Wiki A6 490 rejection by clearinghouse for BCBS advantage plan

[notatthebeach@gmail.com]

Hi!!! I have recently been hired on to help with cleaning up one of my clients aging and clearinghouse rejections. I am running across one that is stumping me. The payor is BCBS of AL Medicare Advantage. It is for a wellness check up and I am getting a clearinghouse rejection code of A6: 490. Rejected for missing information: Other procedure code for services rendered.

I am new to family practice. I have done Medicare in the past for several other specialties. I have tried looking it up and I can't find a definitive answer anywhere on how to fix this.

Please help if you can. I really appreciate it!!!!

 

[amyjph]

Does it have the G codes and the proper add-ons along with the correct dx? It's something to do with the procedure codes they billed.

https://providers.bcbsal.org/portal/resources/-/resource/viewArticle/CLMJDPWJI1

 

[notatthebeach@gmail.com]

Does it have the G codes and the proper add-ons along with the correct dx? It's something to do with the procedure codes they billed.

https://providers.bcbsal.org/portal/resources/-/resource/viewArticle/CLMJDPWJI1

Thanks for the link. I will comb over the claim and make sure all Dx's have a corresponding G code. I think that this is what the issue is.