Claim Corrections during COVID-19

COVID-19 Updates

The number of COVID-19 and telehealth services are growing. A wealth of information from expanded coverage for members, billing and coding guidelines and frequently asked questions can be found on our website. BCBSND’s promise is to continue to provide the most up-to-date COVID-19 related and telehealth services information on our website: https://www.bcbsnd.com/coronavirus/covid-19providers.

BCBSND has expanded benefits and waived limits for certain services to reduce barriers to receiving needed care. BCBSND is evaluating the long-term applicability of these expanded benefits and will provide updates as decisions are made.

Claim Corrections for COVID-19 and Telehealth

BCBSND continues to see changes to billing, coding regulations and mandates. With billing and coding changes, BCBSND is manually reviewing claims and identifying scenarios that were not processed correctly because of missing modifiers, place of service, etc. As a result, BCBSND would like to provide guidance on how and when to make a claim correction during the pandemic.

If a correction is needed for a COVID-19 related or telehealth services:

  1. Void the original claim using a frequency type 8
  2. Once the void has been processed, submit a new updated claim

Here are a few situations on when a claim should be voided, and a new claim filed.

  1. Incorrect CPT/HCPCS code
  2. Missing or incorrect COVID-19 related ICD-10-CM code if applicable
  3. Incorrect place of service or modifier for telehealth related visits
  4. Missing or incorrect COVID-19 related modifier

This applies to only COVID-19 related and telehealth services. The normal claim correction process remains the same for all other services.

We do apologize that this process may be time consuming, but it is necessary to make sure members are receiving the correct benefit during the pandemic.

For further questions, please reach out to Provider Services at 1-800-368-2312 or prov.partners@bcbsnd.com.