Posted in BCBS Empire NY, Training, Updates

BCBS NY: reimbursement policy for Sexually transmitted infections testing.

In this blog post we will look at the new Reimbursement policy that BCBS NY is applying to billing (professional portion) for sexually transmitted infections testing.


Effective 12/01/2021 and thereafter when the provider orders multiple tests- 87491, 87591, and 87661 on the same day and by the same provider; BCBS of NY will consider these tests as part of a group panel grouping and WILL NOT Reimburse these codes separately.

These codes will be bundled together into a more comprehensive panel testing code: 87801.


Definition:

87801-Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique.


Reimbursement of 87801:

BCBS of NY will only reimburse ONE (1) unit for code 87801- no matter how many units was billed on the claim.

The provider is required to bill the other STI CPT codes as rendered. Modifiers WILL NOT override this reimbursement policy.


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Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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