Wiki Appropriate code for billing UDS - BCBS and AETNA

[Vanmathi]

Hi all,

Recently we are receiving denials from AETNA for 2016 claims as " Need to bill with appropriate HCPCS" , currently we are billing 8-series codes for confirmatory tests.

The same issue for BCBS.

Please help on the above cases as we need to bill HCPCS/CPT code for BCBS and AETNA.

Please refer supporting links to check in future.

Thanks
Malarvezhi

 

[ashleykinsey]

The new CMS 2016 UDS codes are G0477 - G0479. If these plans are denying the 8 series CPT codes, I recommend billing the HCPCS G codes.

 

[mamador2]

The new CMS 2016 UDS codes are G0477 - G0479. If these plans are denying the 8 series CPT codes, I recommend billing the HCPCS G codes.

just going to ask the stupid question here...what other set of G-codes, bc I just came across this issue this afternoon w/BCBS as well, educate me please, lol, thanks

 

[CodingKing]

just going to ask the stupid question here...what other set of G-codes, bc I just came across this issue this afternoon w/BCBS as well, educate me please, lol, thanks

Select a maximum of one code from the G0477-G0479 range (Pick the most intensive of the 3 methods used for Presumptive screening)

Select a maximum of one code from the G0480-G0483 range for Definitive based on number of drug classes.

Most of the major carriers have adopted the Medicare codes over the 80000 series codes.

Considering how many payers follow Medicare, its always a good idea to keep up on what they are doing. Especally around 1/1 when all the new codes become official.