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Wiki Well child denial?

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lgirouard14

Networker
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34
Location
Lewiston, ME
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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
 
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.
 
pedihc said:
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
Click to expand...
I am guessing CPT code 99395 needs a modifier
 
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