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CommercialReimbursementMedium impact

Cystourethroscopy Rate Adjustment, Claims Editing & Coding Advice

Blue Cross Blue Shield of Wyoming·WY · Urology·Reimbursement
Effective date
Apr 1, 2023
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSWY is adjusting professional rates for cystourethroscopy procedures (52000-52442) effective April 1, 2023, with new site of service differentials. Additionally, they're implementing stricter automated claims editing in March requiring proper anatomical modifiers on HCPCS codes.

Action Required

Action needed
By April 1, 2023: Billing team must contact BCBSWY Provider Relations for updated cystourethroscopy rate details and site of service requirements. Before March 2023: Update billing system to ensure all HCPCS codes requiring anatomical modifiers have correct modifiers appended (LT/RT for laterality, FA-F9/TA-T9 for fingers/toes, E2 for eyelids) or claims will be denied.

Affected Billing Codes

52000
52442
LT
FA
TA