erinal
Networker
Prior to the 2017 code changes we were billing G0479 and G0480 w/ DX code Z79.899 for our urine drug screens for opioid pain management. We have not had any issues billing this way. Since the new screen code 80307 became effective we have been using it along w/ the G0480 confirmation test, still using Z79.899.
We are getting denials from UHC and BCBS for both codes (80307 & G0480) stating "Rendering provider is ineligible to perform this service" And " The procedure code is inconsistent with the provider type/specialty (taxonomy).
When I called BCBS I spoke with 2 different reps on two different occasions about two different patients but with the same denial. Both reps said that all they actually need is medical records. But they aren't able to tell my *why* they need records. One rep speculated that maybe BCBS has put a flag on those codes to deny until they receive records?? The first rep did pull up our information/taxonomy that is connected to our NPI and she said that they are showing that we are pain management. So now we are sending records on every single BCBS patient who has had a UDS because they are ALL denying for this reason. Every one of them.
I'm puzzled because both BCBS and UHC are denying for the exact same reason. Has anyone else encountered this? Any advice?
We are getting denials from UHC and BCBS for both codes (80307 & G0480) stating "Rendering provider is ineligible to perform this service" And " The procedure code is inconsistent with the provider type/specialty (taxonomy).
When I called BCBS I spoke with 2 different reps on two different occasions about two different patients but with the same denial. Both reps said that all they actually need is medical records. But they aren't able to tell my *why* they need records. One rep speculated that maybe BCBS has put a flag on those codes to deny until they receive records?? The first rep did pull up our information/taxonomy that is connected to our NPI and she said that they are showing that we are pain management. So now we are sending records on every single BCBS patient who has had a UDS because they are ALL denying for this reason. Every one of them.
I'm puzzled because both BCBS and UHC are denying for the exact same reason. Has anyone else encountered this? Any advice?