97112 and Tennessee Blue Cross

[Guest guest]

Hi everyone,

Even thought we are in Idaho, we have a patient who is retaining a Tennessee

Blue Cross policy. We received a denial on the use of the code 97112

(neuromuscular reeducation) with a letter citing that any of these

techniques are " investigational " . While it doesn't affect our practice so

much, I was wondering what Tennessee therapists are doing to fight this.

This is a pretty ridiculous policy statement and I am more worried about

this spreading to other states Blues unless something is being done about

it. Can anyone tell me about what is going on with this in Tennessee?

Thanks

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

thowell@...

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[Guest guest]

Tom,

Are you billing 97112 alone or with 97140 or 97110. We had the same

denials from BCBS when our therapists were billing 97112 alone. According to

the BCBS-LA rep we spoke to, they consider 97112 billed " alone " as not

medically necessary.

Hope this helps.

D. Cavitt, President

Rehab Billing Specialists

Lafayette, LA 70506

In a message dated 7/1/2009 8:44:06 P.M. Central Daylight Time,

thowell@... writes:

Hi everyone,

Even thought we are in Idaho, we have a patient who is retaining a

Tennessee

Blue Cross policy. We received a denial on the use of the code 97112

(neuromuscular reeducation) with a letter citing that any of these

techniques are " investigational " techniques are " investigational " <WBR>.

While

much, I was wondering what Tennessee therapists are doing to fight this.

This is a pretty ridiculous policy statement and I am more worried about

this spreading to other states Blues unless something is being done about

it. Can anyone tell me about what is going on with this in Tennessee?

Thanks

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

_thowell@..._ (mailto:thowell@...)

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

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