Reimbursement Policy Update: Multiple and Bilateral Surgery: Professional and Facility Reimbursement (Policy 06-010, effective 05/01/20)
Effective May 1, 2020, the following updates have been made to the policy:
- Empire BlueCross (Empire) allows reimbursement to professional providers and facilities for multiple and bilateral surgery. Reimbursement is based on multiple and bilateral procedure rules in accordance with contracts and/or state guidelines for applicable surgical procedures performed on the same day by the same provider to the same patient.
- Empire also added language under the Multiple Surgery section to state that a single procedure will be subject to a multiple procedure reduction when submitted with multiple units.
Please visit www.empireblue.com/medicareprovider to view the Multiple and Bilateral Surgery reimbursement policy for additional information regarding percentages and reimbursement criteria.
February 2020 Empire Provider News