BCBSGa to conduct post-service reviews of modifier 91

Beginning in the fourth quarter of 2017, Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (collectively “BCBSGa”) will conduct post-service reviews of professional claims billed with following modifiers: 25, 62, 80, 81, 82, AS, and 91. As part of the review, BCBSGa may contact providers with outlying billing practices to request additional documentation related to the services. If billing discrepancies are identified, BCBSGa will provide a written report of their findings to providers and initiate recoupments as appropriate. Findings may assist your office with quality improvement efforts.