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SC BCBS Blue Essentials 00811 Denials

Hello,

We bill for CRNA’s for anesthesia in South Carolina . We recently have been getting denials for SC BCBS Blue Essentials when we bill 00811 (When screening colonoscopy procedure turns diagnostic) as the reason "Benefit Plan does not cover this service." Is anyone else experience this issue/ have a remedy? We have reviewed the medical policy on BCBS website for our state, asked provider services, and used the Snat Chat option without getting a direct answer if policy has changed. We don’t have access to any of the Blue Essentials policy details.

Thank you!

Medical Billing and Coding Forum