kristina2288
New
Hi All! Hoping someone can help me out. We have been put on prepayment review for BCBS which means we need to submit medical records for all codes billed with a Transvaginal sonogram. We have done so for all patients (2-3 page E&M, 2-3 page Ultrasound report). BCBS has constantly come back on over 15 claims stating that the codes billed do not match the medical records provided - we have been billing 99214 or 99213, 76830 and 93976(59) since we also do a doppler (and the measurements and documentation is provided to them as well). The denials state only "records do not match codes" - i have appealed the denials and requested a formal breakdown and each code why its not covered but they are not complying and the off-shore reps refuse to transfer me to onshore supervisors or the adjustment department. Has anyone gone through this? PLEASE HELP