November 5, 2021

Attn: New York Customers - Front End Edit Implementation

Attention Highmark Western and Northeastern New York submitters:

Beginning 11/16/2021 an operating physician will be required on 837I surgery claims.

On outpatient claims, if the revenue code equals 360-369, 490-499, or 750-759 and the secondary HCPCS code equals 10000 – 69999, then an operating physician must be submitted.

On inpatient claims, if the revenue code equals 360-369, 490-499, or 750-759 and a principal procedure code is submitted, then an operating physician must be submitted.

Beginning 11/30/2021 the patient status must be 30 when the Type of Bill is XX2 or XX3 on 837I claims.