99310 in POS 32... Blue Cross

enascimento

Guest
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5
Location
Providence, RI
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Hello,

I have a few claims sitting on my desk denying because they are stating that 99310 is incompatible with POS 32. Our physicians visit patients in the Nursing Home.

Now - BC has paid 99304-99309's, as this this pts had been in the POS for some time. (Nursing Home bills using POS 32 also)

Any insight why BlueCross dislikes 99310 in POS 32?

Thank you!
 

mitchellde

True Blue
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13,538
Location
Columbia, MO
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2
It may be the diagnosis. The CPT book description states the patient may be unstable or may have developed a significant new problem. This is a high level of service and perhaps they consider it too high for status quo.
 
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