Wiki 0275T MILD being paid on institutional but denied on Professional for Anthem MCR plans.

[leigh@lafayettepaincare.net]

Hello, I am a part of a pain management group and we have been receiving denials on the professional side for 0275T for Anthem MCR plans. I have been billing out 0275T with Q0 modifier and dx codes m48.062 and Z00.6. I have also included the clinical trial number on each claim. The institutional claims paid no problem, but the professionals are coming back as denied and I'm not sure why. We have contacted BCBS several times and they have been zero help. Have you come across any issues?