Definition The GW modifier is defined by Medicare as: “Service not related to the hospice patient’s terminal condition.” This modifier is used when a patient is under hospice care, but the service provided is unrelated to their terminal illness. It alerts Medicare or other payers that while the patient is enrolled in hospice, the billed … Read more
The Health Insurance Portability and Accountability Act (HIPAA) is a cornerstone of the U.S. healthcare system, ensuring the privacy, security, and efficiency of patient data. Enacted in 1996, HIPAA has far-reaching implications for healthcare providers, payers, and patients alike. This article delves into the importance of HIPAA, the key processes involved in medical billing, the … Read more
In medical billing, Modifier 59 is one of the most important tools for making sure claims are coded the right way and paid correctly. This modifier, called “Distinct Procedural Service,” is used when two procedures that are normally bundled together are actually separate and need to be billed individually. If you’re a medical biller or … Read more
24 Modifier In Medical Billing Medical billing relies on precise coding to ensure correct reimbursement for healthcare providers. One essential modifier used in post-operative care situations is Modifier 24. This modifier helps distinguish unrelated evaluation and management (E/M) services provided during a global period from those directly related to the original surgery. This article explores … Read more
25 Modifier In Medical Billing Medical billing involves using specific modifiers to accurately reflect the services provided. Modifier 25 is one of the most commonly used modifiers in medical coding. It allows a provider to bill for an evaluation and management (E/M) service on the same day as a minor procedure when the E/M service … Read more
Insurance Identifier Lookup LAA – LZZ Alpha Prefix BCBS Home Plan Name LAA BCBS of Illinois LAB BCBS of Michigan LAC Anthem BCBS of Kentucky LAE Prefix Not in Use LAF Anthem BCBS of Virginia LAG BCBS of North Carolina LAH Anthem BCBS of Georgia LAI Blue Shield of California LAJ Unknown Assignment LAK BCBS … Read more
Insurance Identifier Lookup KAA – KZZ Prefix Plan Name K2A Blue Cross Blue Shield of Texas K2C Regence Blue Cross Blue Shield of Oregon K2D Blue Cross Blue Shield of Illinois K2F Blue Cross Blue Shield of Illinois K2H BCBS of Western New York K2N Blue Cross Blue Shield of Vermont K2S Premera Blue Cross … Read more
Insurance Identifier Lookup JAA – JZZ Plan Identifier Plan Name J2A Highmark BCBS of Pennsylvania J2B Regence Blue Cross Blue Shield of Oregon J2F Blue Cross Blue Shield of Illinois J2G Blue Cross Blue Shield of Illinois J2M Empire Blue Cross Blue Shield J2N Blue Cross Blue Shield of Georgia J2P Blue Cross Blue Shield … Read more
Prefix Plan Name I2A Blue Shield of California I2C Anthem BCBS of Colorado I2F Blue Cross of California I2I Blue Cross of California I2P Regence BCBS I2T Regence BCBS I2V Anthem Blue Cross of California I2W Regence BCBS I3H Blue Cross Blue Shield of Alabama I3L Capital Blue Cross I3T Anthem BCBS of Virginia I3W … Read more
Prefix Plan Name H2A Blue Cross Blue Shield of Illinois H2B BCBS of Western New York H2C Blue Cross Blue Shield of Illinois H2D Blue Cross Blue Shield of Illinois H2F Anthem BCBS of Indiana H2G Blue Cross Blue Shield of Texas H2H Blue Cross Blue Shield of Arkansas H2J Blue Cross Blue Shield of … Read more
