Electronic Claim Alert: Duplicate Modifier Rejections to Begin June 19, 2013
Electronic claims (ANSI 837P and 837I) containing duplicate modifiers on a single service line will begin rejecting as of June 19, 2013, when submitted to Blue Cross and Blue Shield of Texas (BCBSTX) through Availity®. Claims submitted to BCBSTX from Passport/Nebo Systems will begin rejecting effective June 21, 2013.
An example of a submission with duplicate modifiers on a single service line is as follows: Current Procedural Terminology (CPT®. ) code 73630 with modifiers 26, RT, RT.
This edit will apply to professional claims (Loop 2400, SV101-6) and institutional claims (Loop 2400, SV202-6). To help ensure your claims are accepted, please review them prior to submission to verify that you have not duplicated any modifiers on a single service line.
If you use a billing service or clearinghouse, please make sure they are aware of this information. If you have any questions regarding this notice, contact our Electronic Commerce Center at 800-746-4614.
CPT copyright 2012 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.
Availity is a registered trademark of Availity, LLC. Availity is a partially owned subsidiary of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the Blue Cross and Blue Shield Association. Availity operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX, a Division of HCSC. Availity is solely responsible for the products and services it provides.
Passport Systems/Nebo is an independent third party vendor and is solely responsible for the products and services it provides. BCBSTX makes no representations or warranties regarding independent third party vendors. If you have any questions or concerns about the products or services they offer, you should contact the vendor(s) directly.