Wiki EMPIRE BCBS denies CPT 81002,81003

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bsrinivasarao777

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Hi, Empire BCBS Healthplus CHP insurance always denying CPT 81003,81002 service charges inclusive with E&M service.
Please suggest me is there any BCBS reimbursement policies regarding this issue?




Thanks.
Srinivasarao.b
 
We have always been paid separately by Empire BCBS for 81002. We recently purchased urine dip analysis machines and began billing 81003. They denied. According to my rep they have a set policy written in to their claims process logic that excluded payment of 81003 in addition to and E/M. Although it made no sense to me why they would pay the one and not the other, I was told it would be too costly and too large of a project for them to rewrite the logic to allow the 81003 and they refused. This went before a committee. We were basically told too bad and have since done away with the machine as my providers found the results to be questionable any way. You should not be denied for the 81002 though.
 
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