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November 9, 2018

Attn: New York Customers - New Anesthesia Modifier Editing For BCBSWNY, BSNENY, and HNNY

An EDI Front End edit will be implemented in approximately 30 days, that will require an Anesthesia Modifier when an Anesthesia Procedure Code is submitted. This edit will impact professional claims.

Blue Cross and Blue Shield of Western New York, Blue Shield of Northeastern New York, and HealthNow New York professional claims submitted with an Anesthesia Procedure code (2400 SV101-2 = 00100-01992 or 01999) will require an Anesthesia Modifier (2400 SV101-3 through SV101-6),  Appropriate Modifiers include: AA, AD, AG, QK, QX, QY, or QZ.  Service lines submitted without one of the appropriate modifiers in SV101-3 would receive this error: A6:453.

Special Note:  This edit is bypassed for CPT code 01996.

 

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