Administrative Update for Reporting Multiple and Bilateral Surgery

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will be updating our reimbursement policy for Multiple and Bilateral Surgery, effective June 12, 2024. Aligning with industry standard, Blue Cross NC is instructing providers to submit 1 (one) in the units field for bilateral procedures indicated by Modifier 50. Previously, Blue Cross NC instructed providers to bill 2 (two) in the units field.

This change will align with current practice and billing requirements for the Senior Market Administration (SMA) line of business.

Please review the March 1, 2024 reimbursement policy notification that was communicated previously for commercial plans for further information.

This communication applies to State Health Plan (SHP), Administrative Services Only (ASO), FEP, Fully Insured, and IPP Host. It does not apply to Senior Market Administration (SMA) or IPP Home claims.