Billing for Medicare Excluded Services

In a previously published news bulletin (#399, January 2018), it was advised that if billing for a Medicare-Excluded service and the patient had Medicare primary, the claim could be filed directly to Blue Cross Blue Shield of North Dakota (BCBSND) with the GY modifier and it would be processed. This is no longer accurate.

With the migration to our new platform, we are no longer able to process claims directly for Medicare Excluded services when Medicare is primary. If a patient has Medicare primary, the claim must be filed to Medicare regardless if it is an excluded service. If it is not submitted to Medicare first, the claim will deny to file to Medicare.