BCBS of TN doesn't pay for 97112

[Guest guest]

Hi Group,

We just got an EOB for a pt who has their BCBS from Tennessee, we are in NM.

This pt has a history of numerous falls and balance problems. So, we worked on

all of that and charged it as Neuro-muscular rehab 97112 and it came back

denied, stating it is investigatioanl and experimental. What?!

Even though this pt has had significant improvement and no falls. Any

suggestions on how to get these services paid. Do you mean to tell me that there

isn't enough evidence out there proving that working on someones neuro-muscular

system decreases their risk of falls?

This is one of the many reasons why I want to see some health care reform.

Lydia Radosevich,PT

New Mexico