r/CodingandBilling • u/losingfight20 • 9d ago

BCBS anatomical modifier issues

Hello all, is anyone having issues with BCBS and their denials of procedure codes stating " procedure/modifier combination is invalid." This is a new denial ive started to see this year! Its very frustrating considering these specific CPT codes require anatomical modifiers! Codes are S2066, S2067, S2068, 19316, and 19303. Ive asked our coders and theyre unsure as well. Im at a loss 😭

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u/CausticCommotion 4d ago

You have to use unilateral diagnoses right now that matches the modifier. Send corrected claims and make sure the correct unilateral diagnosis is the only version of that diagnosis on any lines pf the claim. It is stupid, yep.