blue cross

  1. B

    Wiki BCBS Mod 50 & 51

    Hello! In our office we are having some discussion about bilateral injections and the modifiers needed for Blue Cross specifically. For example if we are billing a 20610 with a diagnosis of M17.0, we would use mod 50 to indicate a bilateral procedure being performed. However we have also been...
  2. RaveenaS

    Wiki What in the world does this mean??

    Can someone please tell me what this means??? BCBS is not helping at all with the explanation when only ONE doctor performed 47562. (Dx: K80.10) Patient only has ONE gallbladder, so I don't get it. I got this message back when I asked where to send my PDR. They're seriously fighting me on...
  3. S

    Wiki BCBS denying malignant excisions as benign?

    We have recently recieved an influx of denials on malignant excisions for basal cell carcinoma due to the fact that --according to BCBS-- BCC is considered benign "because it is unlikely to metastasize". There is a whole slew of things wrong with this statement, and with the implications on...
  4. 5

    Wiki Diagnosis codes alphabetical order

    Hello, we just received a denial from blue cross that said: We are unable to process the claim: 203 diagnosis codes must be entered in alphabetical order a-l 019 invalid diagnosis code pointer has anyone else had this type of an issue? Thank you!
  5. S

    Wiki Billing 64405 DX M5481 to BCBS Denied

    We bill 64405 (greater occiptal nerve block) with DX M5481 (occiptal neuralgia) to Blue Cross, they deny stating non-covered. When patient contacts BCBS, they advise patient, denial is due to the diagnosis we are billing. However, M5481 occiptial neuralgia is the reason for the occipital nerve...
  6. B

    Wiki Billing secondary insurance VS writing off as small balance

    My director has decided that if the primary insurance processes a claim and leaves less than $5.00 to the secondary insurance, that instead of billing the secondary insurance she would rather write it off as a small balance. Is that OK? I am having a hard time seeing any verbiage to back up...
  7. E

    Wiki Blue Cross Denial for POS 32 w/ 99310

    Hello, I have a few claims sitting on my desk denying because they are stating that 99310 is incompatible with POS 32. Our physicians visit patients in the Nursing Home. Now - BC has paid 99304-99309's, as this this pts had been in the POS for some time. (Nursing Home bills using POS 32...
  8. E

    Wiki 99310 in POS 32... Blue Cross

    Hello, I have a few claims sitting on my desk denying because they are stating that 99310 is incompatible with POS 32. Our physicians visit patients in the Nursing Home. Now - BC has paid 99304-99309's, as this this pts had been in the POS for some time. (Nursing Home bills using POS 32...
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    • 99310 blue cross denial nursing home pos 32
    • Replies: 1
    • Forum: E/M
  9. M

    Wiki Device Checks

    Does anyone know if a device check and interpretation are done on seperate days do we bill the interp with the date of the device check or the date that we actually read it?
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