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August 2018

Reminder: List primary procedure codes first when submitting claims

In response to recent billing issues that have caused some claims to be rejected, we’d like to remind you to list primary procedure codes first when submitting claims to ensure timely and correct processing. Without the primary code on the first line, the system may reject either part, or all, of the claim. The rejection will indicate “services not payable if not billed in combination with another payable service.”

For example, if 77067 (screening mammogram) is billed along with 77063 (screening digital add-on), 77067 should appear first in the claim with 77063 on a lower line.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

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