Reimbursement Update for COVID-19 Vaccine

Blue Cross Blue Shield of Wyoming welcomes the arrival of safe and effective vaccines as a key component in the national and local COVID-19 response.  The administration costs of vaccines will be reimbursed by BCBSWY and there will be no cost share required from the member.

Each vaccine has its own code and administration n code. Since the Pfizer and Moderna vaccines require two doses, each vaccine has two administration codes to indicate which dose was administered. Please see the table below for coding guidance.

Manufacturer Vaccine Description Administration Codes
Pfizer 91300 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use •0001A (1st dose)
• 0002A (2nd dose)
Moderna 91301 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use • 0011A (1st dose)
• 0012A (2nddose)

 

Coding Reminder-Breast Tomosynthesis

To avoid problems with claim processing, please remember Digital Breast Tomosynthesis (DBT) will only be reimbursed when done in conjunction with traditional 2D mammography as an add on service.

  • 77063 Screening digital breast tomosynthesis, bilateral; add on
  • G0279 Diagnostic digital breast tomosynthesis, unilatera l or bilateral; add on

Behavioral Health Reimbursement Guidelines

BCBSWY recently updated billing and reimbursement guidelines specific to behavioral health, review the guidelines here .

BCBSWY Mailing Address:
PO Box
2266, Cheyenne, WY 82003 2266

Blue Cross Blue Shield of Wyoming is an independent licensee of the Blue Cross and Blue Shield Association

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