Cystourethroscopy Rate Adjustment, Claims Editing & Coding Advice

Holiday Closure

As a reminder, BCBSWY will be closed Feb. 20, 2023 in observance of Presidents Day. We hope everyone has a wonderful holiday.

Cystourethroscopy Rate Adjustment

Effective 4/1/2023, BCBSWY will adjust our professional rates for cystourethroscopy procedures (52000-52442). Going forward these codes will recognize a site of service differential. For more details contact Provider Relations.

Advanced Claim Editing

We are sharing coding advice to help Providers prepare for our automated claims review process starting in March. These ongoing tips help ensure your claims are properly coded.

Coding Advice – Anatomical Modifier

Anatomical modifiers need to be appended to any HCPCS procedure code defined as requiring an anatomical modifier, or it will be denied. In addition, any anatomical modifier that is appended to a procedure code that does not match the anatomical site indicated by the modifier will be denied.

  • Example – X-Ray of the left wrist would require the modifier of -LT.
  • Example – Procedures involving fingers or toes will require modifiers of FA-F9 or TA-T9
  • Example – Incision of the left lower eyelid lining will require modifier -E2


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