Wiki BCBS denied

[Hernf]

I receive this from BCBS

PI-97 the benefit for this service is include in the payment/allowance for another service/procedure that has already been adjudicated

please anyone has the same? bcbs of alabama dont pay for 36415? do I need a MOD?

thanks in advance

 

[xlbctso]

The following is posted on the BCBS Alabama web site - provider manual

Home > Providers > Manuals > Provider Manual > Blood Collection Fee - Venipuncture
Blood Collection Fee - VenipunctureBlood collection fees are the only collection fees covered for venipuncture. Collection of throat cultures, Pap smears, etc., are considered part of the office visit.

Benefits are only provided when laboratory services are sent to an independent laboratory. The independent clinical lab provider should file the venipuncture to the Blue Plan in the state where the specimen is drawn or obtained, regardless of your contract status with that Plan.

It is not appropriate to bill for or up-code an office visit due solely to the collection of a specimen.

 

[Hernf]

thank you very much I found it in BCBS of Alabama