Material Adverse Change (MAC)

 

Beginning with dates of service on or after October 1, 2022, Empire BlueCross BlueShield will implement the following:

  • 96365, 96369, 96372, 96373, 96374, 96379 will deny when reported with 78265, 78830 or 78835.
  • 95957 will deny when reported with 95700 on the same day:
    • The reference to subsequent dates of service was removed from this code pair.

 

For specific policy details, visit the Reimbursement Policy page at empireblue.com/provider.

 

NYBCBS-COMM-001910-22-CPN1910

 



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July 2022 Newsletter