Anthem – Laboratory and Venipuncture Services – Professional and Facility Update

Beginning with dates of service on or after June 1, 2024, Anthem Blue Cross and Blue Shield will update the Laboratory and Venipuncture Services – Professional and Facility reimbursement policy. Beginning with dates of service on or after June 1, 2024, Anthem will update the Related Coding section in the Laboratory and Venipuncture Services – Professional and Facility reimbursement policy.

Since the last policy review, identified that the following language was inadvertently removed from the Modifier 26 comment in the Section II: Modifiers code list:

• When a professional provider has reported modifier 26 to procedure codes designated with NPFSRVF PC/TC indicators 3 or 9, the procedure will not be eligible for reimbursement. This language will be reinserted, and impacted claims will automatically be reprocessed.

Source: https://files.providernews.anthem.com/3947/COBCBS-CM-049674-24-Laboratory-and-Venipuncture-Services---Comms-FINAL_v2.pdf