I am in billing for an urgent care group in Texas. Many of our patients have Blue Cross and Blue Shield of Louisiana, and their plans invariably deny code J1100 as "invalid", even with -25 modifier appended to the E/M. Our local Blue Cross affiliate regards this as a payable code, and that is about all the information I can get from BC. Has anyone had experience with this, or have any ideas how we might get these paid?
We generally bill the J1100 with an E/M (99213 or 99214) and 96372 with a -25 modifier appended to the E/M. Most often the diagnosis is J01.90.
Thanks.