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February 2018

Clinic visits no longer covered for Blue Cross Medicare facility outpatient claims

Blue Cross Blue Shield of Michigan will no longer pay clinic visits (revenue codes Y5100 to Y5190) for UAW Retiree Medical Benefits Trust members with Medicare secondary coverage. Due to a system glitch, Blue Cross had been paying many of these claims in error. While we don’t plan to recover previously paid claims, new claims for service starting Jan. 1, 2018, are being denied as a member liability. URMBT doesn’t cover clinic visits.

Claims affected by this change include group numbers 71400, 71434, 71435, 71472 and 71436.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
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