CommercialAdministrativeHigh impact
Top Billing Issues and Errors and How to Avoid them for Institutional Providers
Blue Cross Blue Shield of Wyoming·WY·Reimbursement
We identified it
Jun 19, 2026
Summary
BCBS Wyoming has identified 8 common billing errors that cause claim suspensions and denials for institutional providers. Key issues include improper bilateral procedure billing (use modifier 50 instead of separate RT/LT modifiers), missing Present on Admission indicators, and invalid operating physician IDs for specific revenue codes.
Action Required
Immediately: Billing team must update claim submission processes to: 1) Use modifier 50 for bilateral procedures instead of separate RT/LT modifiers, 2) Ensure Present on Admission indicators are included in all diagnosis segments, 3) Report operating physician for outpatient claims with revenue codes 360-369, 490-499, or 750-759 when using HCPCS codes 10000-69999, 4) Verify Other Payer Primary ID matches line level Other Payer ID, 5) Use patient status code 30 for interim bills (bill types **2 or **3). Review all current claim templates and staff training to prevent these common denial reasons.