CommercialAdministrativeHigh impact
Claims, Coding, URAC Guidelines & More
Blue Cross Blue Shield of Wyoming·WY·Coding
Effective date
Mar 1, 2023
We identified it
Jun 19, 2026
Summary
BCBSWY is implementing automated claims review starting March 2023 that will deny excess units when billing multiple units with anatomical modifiers (E1-E4, FA-F9, TA-T9) or when exceeding daily/annual unit limits. Additional updates include telemedicine guidance effective Nov 16, 2022, and directory validation requirements every 90 days under the No Surprises Act.
Action Required
Before March 2023: Billing team must review all claims with anatomical modifiers (E1-E4, FA-F9, TA-T9) to ensure only one unit is billed per code. Update billing system edits to flag multiple units with these modifiers. Verify daily and annual unit limits for all procedures in billing software to prevent automated denials. Immediately: Update provider directory information every 90 days using Availity Portal Directory Validation tool to comply with No Surprises Act requirements.