Wiki 92587, 99051

[rhuelar]

Please help.
Two issues with insurance companies:
1) 92587 - one of the services done during a well-child exam; not paid when billed using DX V70.0 or V20.2. What makes this reimburseable?
2) 99051 - not payable due to bundled with the other E/M code. Is there a way to appeal this and get paid?

Any help is greatly appreciated.
Thank you.

 

[HBULLOCK]

As for the 92587 i bill that every day in pedi with the well child exams and 90% of my payers do pay that with dx v20.2 or v70.0. I'm not sure why you are getting denials but i would appeal to see what the issue is. 99051 we also bill but the only insurance that pays it is medicaid. My commercial and bc carriers do not pay that code, they bundle it. Hope that helps.

 

[rhuelar]

As for the 92587 i bill that every day in pedi with the well child exams and 90% of my payers do pay that with dx v20.2 or v70.0. I'm not sure why you are getting denials but i would appeal to see what the issue is. 99051 we also bill but the only insurance that pays it is medicaid. My commercial and bc carriers do not pay that code, they bundle it. Hope that helps.

Thanks for responding ....
What DX code do you use for 92587 when you bill? and you still don't get paid? Do you bill this service to the patient?

99051 - do you just adjust it? if payers don't pay, why bother billing for it?

Your thoughts?
Thanks.

 

[HBULLOCK]

We Do get paid for the 92587 for almost all payers. We use v20.2 or v70.0 depending on the age of the pt. If the insurance denies we bill the bill as stated by the insurance company. Many times they apply this to the patients deductible/co-ins. When it comes to the 99051 the only way you can get payers to recognize this code and pay is to bill it. If you never bill it, noone has a chance to pay it. Just like when you have a new code sometimes it takes a while for all carriers to come around and pay for it. Hope that helps.