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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Past Blogs:
- NYS Medicaid OBGYN CPT II codes reporting requirement
- NYS Medicaid: Bariatric Surgery Medical Policy Update
- NJ Medicaid: Sickle cell Disease Generally Therapy- billing and coding
- Hedis Measure: Controlling Blood Pressure Controlling Blood Pressure
- North Carolina Medicaid- self collected HPV test info.
KR2 Medical Billing 