March 22, 2012

 
 
 
 

BC-12-5
MS-12-5
 

To:

All Blue Cross and Blue Shield of Kansas Contracting Providers

From:

Connie Winkley – Education/Communication Coordinator
Institutional Provider Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

Molecular Pathology Lab Code – CPT codes 81200 - 81408

Effective January 1, 2012, Blue Cross and Blue Shield of Kansas (BCBSKS) no longer accepts stacking codes for molecular pathology testing when there is a pure valid code that actually names the test. If a stacking code is billed after January 1, 2012 when a pure code is available to use, the claim will be returned with a request to resubmit with the pure code. If no pure code exits, then it is acceptable to bill the stacking code. If a stacking code is used because a pure code is not available, then BCBSKS requires documentation to know what service is being provided.

The use of pure codes for molecular pathology testing, rather than stacking codes will benefit the provider with a reduction in both returned claims and the R04 request sent from BCBSKS. In addition, it will allow the provider to submit the claim paperless due to records not being requested.

If you have questions regarding stacking codes, please contact your BCBSKS Provider Representative.

 

cw