Thank you in advance!
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Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers Click here for more sample CPC practice exam questions and answers with full rationaleTag Archives: BCBS
Can anyone tell me if BCBS is now accepting the screening G codes? I billed a screening colonoscopy with Z12.11 and 45378, and they did not cover the cost as a screening. They told the patient that it needs to be billed as a screening for them to waive the copay.
Anthem BCBS Denying 2nd Eye Cataract Surgery
Is anyone having issues with Anthem denying/rejecting the second eye cataract surgery within global of the first eye as "modifier used is inconsistent with procedure?"
66984 – RT w/ ICD-10: H25.811
66984 – 79, LT w/ ICD-10: H25.812
We have never had issues before and cannot get through to a live provider or customer service rep. Thank you for any suggestions.
BCBS Denial of 99213-25 with 98940/98941
I am New to Chiropractic billing and the provider is receiving denials for his established E/M visits when billed with a 98941-98942. New patient visits are paid with no issues, correct -25 modifier is being used, separate and billable diagnosis are used. Any suggestions?
Thank you for any help!
Thank you for any help!
BCBS denying mod 59 on vaccine administration code 90471
Recently, we have gotten several denials from various BCBS plans for modifier 59 on vaccine administration code 90471. The remark code says "procedure modifier was invalid on date of service". One patient called BCBS and was told modifier 59 is invalid on this service. Is this a glitch within BCBs or has something changed with modifier 59 guidelines? I’ve searched online and can’t find any changes where I should not be allowed to use modifier 59 on the administration codes. Example of charges:
99215 mod 25
90670-for pneumonia vaccine medicine
90471 mod 59 for vaccine admin code
Claims Denying from BCBS for LDL Cholesterol
We have began getting denials from BCBS regarding the LDL Cholesterol test (CPT 83721) stating that due to NCCI, it is not billable seperate if Triglyceride is >= 400mg/dl. We have never been denied before. Is anyone else having this issue recently? In reading the NCCI edits, this is correct but confused b/c we have never been denied before.
Billing BCBS for extra prenatal visits for High Risk Patient
Does anyone know how to get paid by BCBS for prenatal visits that exceed the normal 13? High risk patient.
Billing to BCBS
Good afternoon,
One of my colleagues is having a heck of a time getting BCBS to process her lab billing. For example: If the sample is being pulled from a patient residing in Texas, but the sample is being tested and results read by her lab company in Georgia, then what state should we bill to?
One of my colleagues is having a heck of a time getting BCBS to process her lab billing. For example: If the sample is being pulled from a patient residing in Texas, but the sample is being tested and results read by her lab company in Georgia, then what state should we bill to?
It seems that they’re getting the run around. Thank you!
BCBS Denying WWE exam code??
Hey there! Looking for suggestions… BCBS is denying a wwe visit with the code 99395. I have never billed a wwe any other way (except for a new pt).
They have said that it is a medical code not a wellness visit?? The only other codes I see for wellness type exams are the G codes for medicare which doesn’t apply.
Any suggestions?? I am at loss! 14yrs OB coding…never ran into this!
They have said that it is a medical code not a wellness visit?? The only other codes I see for wellness type exams are the G codes for medicare which doesn’t apply.
Any suggestions?? I am at loss! 14yrs OB coding…never ran into this!
BCBS TX nonpayment of E/M with modifier 24
Tubes and adenoids are performed. Pt comes in 30 days later and has audio. Doctor codes 99213, 92557, 92550. Modifier 24 is on OV. Diagnosis is only for the ears. No adenoids mentioned. BCBS is refusing payment for office visit, saying it’s within global. Not sure what is wrong here. Help! Thanks!
BCBS Modifier Denials
Is anyone else getting denied for claims with modifier 25, 58, and/or 59?
Denial reason: The procedure code is inconsistent with the modifier used or a required modifier is missing.
Denial reason: The procedure code is inconsistent with the modifier used or a required modifier is missing.
Every single claim we have submitted this year is getting denied. I have submitted claim reviews with medical records and it has been over 60 days. The claim reviews are still processing. I wanted to see who else is having the issue and what steps are you taking to get the claims paid.