Coding Advice: Claims Coding Tips For Faster Approval

Please note the following errors that often lead to claims denial when not properly coded:

  • BCBSWY will deny Column II procedure codes billed with associated Column I procedure code by same provider and a modifier is not supported. Supporting information such as claims history and all diagnosis codes are reviewed. Please ensure you are billing all diagnosis codes to support modifiers 59 and 25.
  • J2001 will deny when used as a local anesthetic and is bundled into the service rendered at the same time.
  • Claim lines reported with mutually exclusive code combinations according to the ICD-10-CM Excludes 1 Notes guideline policy will be denied.
  • Procedures or services received with a secondary diagnosis code as a principal or primary diagnosis will be denied.
  • Any service when billed with an invalid or deactivated NPI will be denied.
  • Claim lines containing invalid NDC numbers will be denied.

Share

Related Posts
ASC Reimbursement Update
ASC Reimbursement Update Blue Cross Blue Shield of Wyoming is committed to providing you with updates on upcoming policy and reimbursement changes. Effective, 9/1/24,…
Medical Policy Update
Prior Authorization Submission Reminder BCBSWY is committed to improving communication and knowledge of medical policy updates. Effective 9/1/2024, BCBSWY will implement a new medical…
Reimbursement Update May 16-2024
Prior Authorization Submission Reminder Providers should be using the online prior authorization submission portal in Availity. It is now live and fully accessible. To…

Fewer Hassles. Better Service.