Online Prior Authorization Updates

We are actively working to correct a system issue with online authorizations displaying the incorrect effective and expiration date of an authorization. This is affecting all authorizations. In the interim, you can validate the authorization period by the following:

  • Reviewing the fax correspondence, which is sent in real-time at the time of determination;
  • Reviewing the letter, which is mailed the day after determination;
  • Or calling our Member Services Department.

In the coming weeks, a detailed section will be added to our online tool and will include the following:

  • For inpatient, it will display the length of stay approved from admit date through the most recent concurrent review.
  • For outpatient, it will display the approved authorization period per CPT or HCPCS code submitted.

We appreciate your patience as we complete our system upgrade to improve prior authorization efficiencies. We’ll continue to update you on how to utilize this new authorization tool best and let you know as soon as this issue is corrected.

CPT Code 96380 and 96381 Billing Tips

Blue Cross Blue Shield of Wyoming regularly develops and revises coding and reimbursement policies and updates to the coding sets. Our commitment is to update the provider community as coding and reimbursement policies are adopted and/or revised.

  • Two new CPT codes for RSV were released this week with a retrospective effective date of 10/6/2023. This means for any date of service 10/6/2023 and forward, BCBSWY will accept this code on a claim form. Any date of service prior to this date will reject as invalid as the code is not effective.
    • Codes 96380 and 96381
  • We are currently programming our system to accept these new codes. We expect all programming to be implemented by Monday, Oct. 23. If you submit prior to this date and receive any type of error such as an ECP error for electronic submissions, please attempt resubmission on, or after 10/23/2023.
  • Best practice TIP: Hold claims with either of these CPT codes until on or after 10/23/2023

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