I do billing for an optometrist who is mobile. He goes to nursing facilities and does patients eye exams and glasses fitting. I am getting an odd denial from BCBS (secondary) for his vision exams. Which is PR-58-Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service.

I find it very odd that as primary they pay exams just fine but as secondary they don’t? Has anyone else had this issue? They will allow lets say 23.24 for co insurance but put it as that denial reason. I could kick to patient but just find it very weird that they are allowing this service but denying it for POS which is 32-Nursing Facility. Any advise is appreciated!