CommercialAdministrativeHigh impact
Top Billing Issues and Errors and How to Avoid them for Professional Providers
Blue Cross Blue Shield of Wyoming·WY·Reimbursement
We identified it
Jun 19, 2026
Summary
BCBSWY has identified common billing errors causing claim denials and suspensions. Key issues include incorrect bilateral procedure billing (use modifier 50, not RT/LT separately), missing or incorrect NPIs, invalid taxonomy codes, incomplete addresses, and anesthesia modifier requirements.
Action Required
Immediately: Billing team must update claim submission processes to use modifier 50 for bilateral procedures instead of separate RT/LT modifiers. Verify all NPIs are current with BCBSWY Provider Relations. Ensure taxonomy codes in box 24j match services provided. Use physical addresses with complete 9-digit zip codes (no PO boxes). Add anesthesia modifiers AA-AE, GC, QX, QY, or WP when billing provider is not a CRNA. Include referring provider NPIs for labs, imaging, and DME. Review CCI edits to avoid bundled service denials.