CPT Code 83036 Billing Tips

BCBSWY would like to encourage Providers billing CPT code 83036 to include the category claims as this will be a focus beginning Jan. 1, 2024.

For best habits, please begin using the below guidance now to ensure proper categorization.

CPT 83036 for a HbA1c laboratory test will need the appropriate Category II code on the same claim.

CAT II codes are an informational code and should be billed with either a $0.00 charge or a $0.01 charge if required by your system or clearing house.

CAT II codes are for diagnostic/ screening processes or results.

Category II Codes for HgbA1c

Codes Code Usage

  • 3044F-HbA1c —– Less than 7.0%
  • 3051F-HbA1c —– Greater than or equal to 7.0% and less than 8.0%
  • 3052F-HbA1c —– Greater than or equal to 8.0% and less than 9.0%
  • 3046F-HbA1c —– Greater than 9.0%

Annual Wellness Reminders

BCBSWY encourages Primary Care Providers to remind your patients to schedule an annual wellness visit. Annual exams are essential. We know that regular preventive care is one of the best ways to identify and treat health issues before they get worse.

Click here to see the complete list of preventive benefits that BCBSWY covers.

Provider Directory Validation Tool Reminder

Reminder:

  • You can now find the guide under the ProviderResources section on the right of the website.
  • Providers can use the Directory Validation tool on the Availity Portal to find NPI and tax ID combinations.
  • The No Surprises Act (NSA) requires you confirm this information with us every 90 days.
Provider Resources:

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