Announcing claim editing updates to our screening policy for abdominal aortic aneurysms

In December 2018 and April 2019, Blue Cross Blue Shield of Michigan made updates to our claim editing processes for select groups. When we informed you of these changes, we let you know that we were doing this to:

• Promote correct coding
• Make our claims payment system easier for you and your billing staff to navigate 

We’ve also made updates to our claim editing system for screenings for abdominal aortic aneurysms (CPT code *76706). Please be aware that a screening for abdominal aortic aneurysms isn’t recommended for the following patients and, as a result, you may experience claim denials:

• A female patient and a diagnosis of family history of abdominal aortic aneurysms  isn’t present on the claim.
• A male patient younger than age 65 and a diagnosis of family history of abdominal aortic aneurysms isn’t present on the claim.
• A male patient older than age 75 and a diagnosis of family history of abdominal aortic aneurysms isn’t present on the claim.

Note: For an ultrasound or duplex ultrasound of the abdominal aorta other than screening, use CPT codes *76770, *76775, *93978 and *93979.

If you have questions about the Blue Cross’ claim editing process, contact Provider Inquiry – Professional at 1-800-344-8525 or Provider Inquiry – Facility at 1-800-249-5103.