AdministrativeCommercialJune 1, 2024

Implant — Facility Editing update

Effective for all claims received on and after September 1, 2024, Anthem is updating its outpatient facility editing system to deny the following HCPCS codes when billed with revenue code 0278:

A0001–A2012

C1052

A4212

C1600–C1604

A4215–A4217

C1761

A4220–A4221

C1765

A4290

C1787

A4305–A4306

C1748

A4314–A4316

C1818

A4338–A4351

Q4279

A4364

Q4287–Q4304

A4461

V2785

This facility editing update is supported by Anthem’s Implants — Facility commercial reimbursement policy. If you believe you have received a denial in error, please follow Anthem’s standard claim dispute process.

Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare), and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CM-057929-24-CPN57522

PUBLICATIONS: June 2024 Provider Newsletter