Summary
Blue Cross is implementing a new claims-editing software system (CES) for all providers on July 27, 2019, and the system logic will be applied to claims processed on or after the implementation date for most changes. Changes include updated code pair edits, updated max frequency rules, Modifier 50 handling where only one unit per line is billed and additional units are reduced to 1, and new patient visit codes 99201 through 99205 that will deny if the patient has been seen by the same provider within three years from the date of the initial new visit code. The newsletter also says that payments and allowable charges may change once the system is implemented, and it sets the NPI requirement for referring and ordering physicians on all lab claims.
Get alerts when payers change rules like this one
We check Blue Cross and Blue Shield of Louisiana and other payers every day and email you when a change matches your specialty and state.