Wiki Well child denial?

[lgirouard14]

We received a denial from Anthem regarding a well child visit. Stating that the procedure code was not listed on their fee schedule? Of course they did not let us know which procedure code it was and I have replied with that question, but I wasn't sure if someone on here would possibly know the answer. What we billed is...
99395-z00.00
80061-z13.220
36416-z13.220
96160-z00.00
90715-z23
90471-z23
90620-z23
90472z-23

 

[SharonCollachi]

In the Anthem Blue Cross of California Fee schedule, 90620 shows in the notes section: "Err-Procedure Suspend Exists".

90472 shows in the notes section: "AIS-AS-IS SURGERY".

They all have dollar amounts associated. I'm guessing it's the 90620.

 

[wlf78911]

We received a denial from Anthem regarding a well child visit. Stating that the procedure code was not listed on their fee schedule? Of course they did not let us know which procedure code it was and I have replied with that question, but I wasn't sure if someone on here would possibly know the answer. What we billed is...
99395-z00.00
80061-z13.220
36416-z13.220
96160-z00.00
90715-z23
90471-z23
90620-z23
90472z-23

I am guessing CPT code 99395 needs a modifier

 

[lgirouard14]

Sorry, I should have specified, we did have a modifier on the 99395.