Wiki 90460 denials when billing with 17110 at well visit

[sammartin92472]

I am getting denials from BCBS for 90460 (vaccine admin) when a wart removal procedure (17110) is done at the same visit. The denial I am getting is service not covered with other service on same date. I ran these codes through my CCI edit check there is no CCI edit to prevent these two from being reported together and no modifier is needed but I continue to get denials from BCBS. Here is the whole claim:

99394-25
17110
36416
85018
90460
90734

"Technically" this is right but I know BCBS does things their own way so if anyone has a tip other than doing a reconsideration on how to get these paid the first time around, I would love to hear it! Thanks so much.

Samantha

 

[Lashel]

I am getting denials from BCBS for 90460 (vaccine admin) when a wart removal procedure (17110) is done at the same visit. The denial I am getting is service not covered with other service on same date. I ran these codes through my CCI edit check there is no CCI edit to prevent these two from being reported together and no modifier is needed but I continue to get denials from BCBS. Here is the whole claim:

99394-25
17110
36416
85018
90460
90734

"Technically" this is right but I know BCBS does things their own way so if anyone has a tip other than doing a reconsideration on how to get these paid the first time around, I would love to hear it! Thanks so much.

Samantha

Do you have a provider rep at BCBS? This could be something in your specific contract, or it could just be a glitch on their end. I have seen issues where contracts were not negotiated as well as they could be, and we later realize we agreed to something like this when we signed the contract. That is why I would start with your provider rep and they should be able to advise you.