Anthem Blue Cross and Blue Shield and their subsidiary company HMO Colorado (Anthem) announced a reimbursement policy change on February 1, 2018 for CMS-1500 submissions.
The update to the claims processing edits and reimbursement policy states that Anthem considers technology used to assist in the performance of a procedure to be part of the surgical procedure. Medical professionals in Colorado that report ultrasonic guidance, CPT code 76942 will not be eligible for separate reimbursement when reported with tendon injection services represented by CPT codes 20550 (injection(s); single tendon sheath, or ligament, aponeurosis) and 20551 (injection(s); single tendon origin/insertion). Modifiers 59, XE, XP, XS, and XU will not override this edit.
The policy goes into effect for dates of service on and after May 1, 2018.
Nationwide, abeo closely monitors for anesthesia reimbursement policy changes. When they occur the abeo team identifies the client’s that will be impacted and forecasts the potential revenue impact a policy change may have on a specific practice. Our findings are then delivered directly to the client with next steps and recommendations as applicable.
This is one of the many ways we do more for our Colorado anesthesia billing clients. Contact us today for more information on how abeo can partner to add more value to your anesthesia practice by improving financial and operational performance.