New reimbursement policy: Multiple and Bilateral Surgery Processing - Facility*
*Notice of Material Amendment/Change to Contract (MAC)
Beginning with dates of service on or after January 1, 2022, Anthem Blue Cross and Blue Shield (Anthem) will implement a new facility reimbursement policy titled, Multiple and Bilateral Surgery Processing.
Anthem allows reimbursement for only the primary, or highest valued, procedure when multiple or bilateral procedures are performed on the same day or same session, and at the same place of treatment when billed by a facility. A single surgical procedure is subject to multiple procedure reduction guidelines when submitted with multiple units.
October 2021 Anthem Provider News - Ohio