Evaluation and Management (E&M) Notification

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of an identified issue causing an incorrect denial of ANSI CO119 to apply when a routine Evaluation and Management (E&M) visit and a regular E&M visit with an appropriately appended modifier were billed on the same day.

This impacts claims with dates of service 02/16/2022, through 05/11/2022. BCBSND has identified claims that may have been impacted by this issue and will do an additional review. Please allow 45 days for this review to be completed. Claims identified to be denied incorrectly, will be adjusted accordingly.

If you identify a claim that you feel has not been processed correctly after the 45 days has lapsed or have additional questions, contact the appropriate Customer Contact Center listed on the back of the members ID card.

BCBSND asks providers to continue to bill E&M services in accordance with the BCBSND Modifiers 25, 27, 59, FT, XE, XP, XS & XU reimbursement policy.

For additional questions please email prov.partners@bcbcnd.com.