Re: BCBS denying payment for 99202 and 99203.....

[Guest guest]

Resubmit it with a "-25" modifier to indicate that it is a separate 'procedure' done in addition to the CTM code.

Tell them that you neglected to add the -25 modifier.

Oh, and I write: NEW PATIENT INTAKE (or RE-EXAMINATION if it's a 9921x-25 code) in the space above the diagnostic codes that says "Reserved for Local Use" --something like that

And I write "E/M" in the 'modifier's' space.

I almost always get paid. Hope this helps.

Ann DC

(Oh, and PS--You all missed an incredible Aurora Chorus concert today. Full house, standing ovations for both shows. Maybe next time... Best kept secret in Portland... LOL)

BCBS denying payment for 99202 and 99203.....

OK, I don't take a lot of insurance but I just got some payments for BCBS; they denied 99203 and 99202 for reason "N01: This procedure is considered incidental to or part of the primary procedure per National Correct Coding Guidelines"

I believe they are referring to my 98940 or 98941. This is garbage as I had to do pretty substantial histories and exams on these patients and coded accordingly. In the same payment, they paid for a 99203 combined with a 97140 and no 989XX code.

What did we do to ourselves to allow insurance companies to pay us $28-$48 for a 98940 and 98941 AND include any E & M code in that payment???

Here's the deal; I really don't want to spend much time with this as most of my practice is cash and if I spend an hour on fixing it and appealing, I've lost money..... Just wondering if anyone else had problems like this and what you did to remedy it.

-Tim Irving DC, MS, LMT

[Guest guest]

Did you use the 25 modifierSent via DROID on Verizon Wireless BCBS denying payment for 99202 and 99203..... OK, I don't take a lot of insurance but I just got some payments for BCBS; they denied 99203 and 99202 for reason " N01: This procedure is considered incidental to or part of the primary procedure per National Correct Coding Guidelines " I believe they are referring to my 98940 or 98941. This is garbage as I had to do pretty substantial histories and exams on these patients and coded accordingly. In the same payment, they paid for a 99203 combined with a 97140 and no 989XX code.What did we do to ourselves to allow insurance companies to pay us $28-$48 for a 98940 and 98941 AND include any E & M code in that payment???Here's the deal; I really don't want to spend much time with this as most of my practice is cash and if I spend an hour on fixing it and appealing, I've lost money..... Just wondering if anyone else had problems like this and what you did to remedy it.-Tim Irving DC, MS, LMT

[Guest guest]

Hey Tim,

Check out the Pay DC website. They have 2 free webinars that are great. They

cover the 25 modifier in Coding 101. It doesn't have to take up all of your

time.

- Gerbi

Hood River Chiropractic and Wellness

>

> Did you use the 25 modifier

>

> Sent via DROID on Verizon Wireless

>

> BCBS denying payment for 99202 and 99203.....

>

> OK, I don't take a lot of insurance but I just got some payments for BCBS;

> they denied 99203 and 99202 for reason " N01: This procedure is considered

> incidental to or part of the primary procedure per National Correct Coding

> Guidelines "

>

> I believe they are referring to my 98940 or 98941. This is garbage as I had

> to do pretty substantial histories and exams on these patients and coded

> accordingly. In the same payment, they paid for a 99203 combined with a

> 97140 and no 989XX code.

>

> What did we do to ourselves to allow insurance companies to pay us $28-$48

> for a 98940 and 98941 AND include any E & M code in that payment???

>

> Here's the deal; I really don't want to spend much time with this as most of

> my practice is cash and if I spend an hour on fixing it and appealing, I've

> lost money..... Just wondering if anyone else had problems like this and

> what you did to remedy it.

>

> -Tim Irving DC, MS, LMT

>