jklapp8248
New
I'm getting a rejection from blue cross on a 99396 with a v70.0 stating that this diagnosis code is not covered. What other diagnosis' are there?
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Wiki rejection on 99396
- Thread starter jklapp8248
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lcarriza423
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How old is the patient?
btadlock1
Guest
It's probably just an error. Call provider services and ask them:
-Does this patient have coverage for preventive services?
If they say yes, then ask them to look at the DOS and verify that it denied correctly. (I really don't think it did, though).
If they say that the denial is correct, find out why the diagnosis isn't covered (is it an issue with their plan, or are they saying it's coded wrong?)
If they tell you it's a coding issue, ask them what they're basing their rationale on - what rule/guideline supports their denial, and where can you find it?
Either your claim should be sent for reprocessing, or you should gain enough information to figure out where the problem is. Good luck!