Results 1 to 2 of 2

Anthem Federal Bi-lateral billing guidelines

  1. #1
    Everett, WA
    Default Anthem Federal Bi-lateral billing guidelines
    Exam Training Packages
    Working on trying to find an answer to this. Why must it be so "secretive?" Customer service has told us to submit units with no modifier 50, although we have used it successfully in the past up until February of this year. CPT code is 64612. Agent said they have their own guidelines and do not necessarily abide by MCR. I've contacted our Provider Support Rep who referred me to another agent specializing with Federal and I've still received no answer to my question. So, customer service says one thing, past claims payments says another, and now can't get an answer from the one who is supposed to know. What should be my next step to end this run-around?

    ---Suzanne E. Byrum, CPC

  2. Talking Answer to question
    I assume you are using 50 to indicate a bilateral procedure was performed. However most insurance companies want the procedure on two line items and specifiy RT or LT. So it would look like this 64612-RT and 64612-LT. Try that and let me know if it works for you. Remember that most bilateral procedures insurance companies want to see 2 line items vs. just 64612-50.

    Hope that helps you
    Angela Niemi-CFPC

Similar Threads

  1. Replies: 2
    Last Post: 12-10-2014, 01:26 PM
  2. Anthem Guidelines for GI
    By m*larusch in forum Billing/Reimbursement
    Replies: 0
    Last Post: 03-25-2014, 09:23 PM
  3. incident to billing for Anthem
    By Christina Hall in forum E/M
    Replies: 1
    Last Post: 01-14-2014, 10:05 AM
  4. Federal guidelines of FDA approved medical devices
    By ramzeee68 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-23-2013, 03:24 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.