guessing that since 17110 is a procedure which is scheduled and or performed, how can you expect to get paid for a preventive service??? or did you not have a V code diagnosis with the preventive visit code? I really dont see anything preventive about patient's visit.
Date: Wed, 16 Jan 2013 22:31:28 +0000
Subject: [MedicalBillers] Unbundling Proc w/Blue Cross?
Got a denial from Blue Cross today.
99397 - denied
99214-25 - paid
17110-59 - paid
90471-59 - paid
90732 - paid
Blue cross didn't put a "reason code" as to why they denied the 99397. I had to call them to discover why it was denied. They said that according to CCI edits that 99397 has an "unbundle relationship with 17110".(?)
Pt came in for a well adult PE and then a sick visit was also addressed (99214), as he had "a list of concerns"; and then Dr. froze lesions and pt got a pneumonia shot.
I cannot find anything on CCI about this, can anyone else? Should I have billed it with a modifier? If so which one?
Melinda Brown, CMBS
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