Wiki 80104 & Blue Cross Blue Shield

[ediepierre]

I am new to the billing and coding world but this one has confused me. I have billed the 80104 with a QW modifier and it was rejected. I billed it without the modifier and it was STILL rejected. Can someone please help me understand how I'm supposed to bill Blue Cross Blue Shield for this?

The bill is an office visit and urine.
99214 25
80104

 

[capricew]

BCBS in my area has changed their policy and adopted the Medicare G code equivalent of
G0434.
They will not accept the 80104 anymore. Maybe this is true for your area as well. Go to their website and look up the Urine Drug Screen policies.

Good Luck!

Caprice Walder, CPC

 

[ediepierre]

Thank you for responding Caprice We have tried the G0434 (QW for CLIA waived) but they denied that one first. Then, because they are commercial, we did the 80104, which they have denied as well. It's so frustrating.

 

[Dani_k_83]

I may be too late to help but, we use G0434 for our Anthem Commercial Members. I would recommend contacting your BCBS provider rep. They should be able to review the claims and help determine where you are going wrong. Good luck!