Electronic Claim Alert: Duplicate Modifier Rejections to Begin June 19, 2013

June 18, 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 New Mexico (BCBSNM) through Availity®.

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 BCBSNM, a Division of HCSC. Availity is solely responsible for the products and services it provides.

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