I have two separate patients who have Carefirst BC/BS and both are having the end of treatment OTV denied as experimental. The plan, 5 fractions and all other charges during treatment have gone through just fine, and the ICD 10 is appropriate for SBRT. There are no other charges on the date of service that would bundle it and for the life of me I can’t figure out why they are denying it. Anyone else have this problem or know why this is happening?

Thanks