• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki 99214 and 76817

Create Wiki
E

esand12

New
Messages
1
Location
Oxford, PA
Best answers
0
We are a group of specialists in reproductive endocrinology. When our patients become pregnant we normally bill 99214 and 76817 with a dx of O09.01 (supervision of pregnancy with history of infertility, first trimester). Recently Highmark has started denying 76817 stating not a covered service when reported with diagnosis. We have reviewed the Highmark policy and used dx codes listed as covered but they are still being denied. Is anyone else having this issue or can anyone offer some advice?
 
We are also having issues with Highmark lately. Maternal-Fetal specialists seeing denials on 76817, 76811, 76816, and 76805. All denials state the service was not medically necessary or they have reached max benefits for that code. No one from Highmark or BCBS has been able to direct me to a policy which supports these denials.
 
You must log in or register to reply here.
Top