Coding Advice – Modifiers
As of 9/1/2023, BCBSWY will no longer permit the usage of modifiers CO (Occupational Therapy Assistant) or CQ (Physical Therapy Assistant).
Intraocular Lenses Billing Code Change
BCBSWY requests that ASC’s use code L8699 in lieu of the HCPCS codes V2630-V2632 when billing. Please be sure to submit invoices with these
implant claims.
Availity Appeals Best Practices
Please use Availity Appeals only for the following reasons:
- Benefit Denials
- Clinical Denials (not medically necessary/experiment or investigational/convenience)
- Price Increase
All other items like corrected claims, medical record requests, or submission of EOB’s to coordinate claims need to follow the regular
workflow, which is via mail, fax, or Availity documentation upload. By using incorrect channels for submission of these items it causes a delay in
processing and will be required to be rerouted.
New Prior Authorization Tool Coming in Fall
Coming this fall, we’re updating our Prior Authorization tool to save Providers time and to further simplify workflows. Some of the
features include the following:
- View more real-time information in Availity.
- Reduced authorization wait times with an enhanced automated process.
- Use a distinct member name for newborn baby authorizations.
Stay tuned for dates soon.