Does anyone know when Blue Cross started paying for the second procedure as in 45384 and 45385, using a 59 modifier and FT the position as well. Blue Cross in the past always denied this but recently they have been paying on it. Anyone know when and why they started paying it? Thank you
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Wiki getting paid for double procedures ie 45384 & 85
- Thread starter patwesner
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I can't help you out on the dates when BS started paying for these procedures because I've never had a problem with them denying multiple techniques that were billed out (just Medicare) but I found this post interesting so I pulled up BS's website to look. They're still following Medicare's guidelines on billing... when two or more related endoscopies (i.e., in the same family) are performed, the endoscopy with the highest RVU is allowed at 100 percent. Maybe they're paying these by mistake and will come back and recoup if they do any internal audits on these procedures?
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As long as the procedures were performed on two seperate sites in the colon there should be no problem with insurances.