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Blue Cross Recovery attempts IOM Intraoperative Neuromonitoring

S

sslaten06

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3
Location
Ervin, California
I have been dealing with Anthem Blue Cross for a while now wanting refunds on CPT code 95941 stating that they have a multi unit rule that only allows one unit to be paid. However this is a time code, Anthem is being extremely difficult and I can not get any where with them. Does any one have experience with this issue and can advise what action I should take. I have requested Meet and Confers that are not being processed, sent multiple appeals, reported to the insurance commissioner who state they are federal plans they cannot assist. However we are still sending in bills and they are paying the same CPT code for the full amount that is billed or close to the full amount when deductibles and copay are applied.
 
Last edited:
sslaten06 said:
I have been dealing with Anthem Blue Cross for a while now wanting refunds on CPT code 95941 stating that they have a multi unit rule that only allows one unit to be paid. However this is a time code, Anthem is being extremely difficult and I can not get any where with them. Does any one have experience with this issue and can advise what action I should take. I have requested Meet and Confers that are not being processed, sent multiple appeals, reported to the insurance commissioner who state they are federal plans they cannot assist. However we are still sending in bills and they are paying the same CPT code for the full amount that is billed or close to the full amount when deductibles and copay are applied.
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My payor relations people looked into this and the blues across the board will only pay one unit.
 
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