maribel8395
Contributor
I am starting to see a lot of denials for office visit levels 4 with B12 injections and CPT 96372. Documentation is supportive of the level patient has 2 chronic stable conditions, is getting medications refilled, and is also getting their normal B12 injection. ERA code for BCBS is V55 not reimbursable following coding validation the more comprehensive 96372 includes the component service described by 99214, therefore 99214 is not reimbursable. So they paid the B12 and admin code but not the OV. And there was a 25 mod on office visit.
Anyone else having this issue?
Anyone else having this issue?