Update: BCBSNC Claim Filing Guidelines for CMS “X” Modifiers

This communication originally posted in early 2015 is being reissued on February 11, 2016, to clarify when to use the “X” modifier when filing claims:

• Blue Cross and Blue Shield of North Carolina’s (BCBSNC’s) commercial products:  Report modifier 59 on claims when applicable, and only include an X modifier when applicable.

• BCBSNC’s Blue Medicare HMO^SM and Blue Medicare PPO^SM products: Report modifier 59 on claims when applicable, but do NOT include X modifiers at this time.

BCBSNC is no longer requiring that these claims be submitted with both the 59 modifier in the first position, as well as the “X” modifier on the claim. The provider can now submit the appropriate “X” modifier in the first position or only, which will process accordingly based on the Modifier Guidelines Corporate Reimbursement Policy.