Wiki BCBS OK UAs G0659

[AprilWinters]

Are we the only clinic having issues getting paid for UAs from BCBS Oklahoma? We literally have not received payment for any this year, the only thing our provider rep has stated is that we need to submit records and we have done that, repeatedly. We bill out an office visit with the G0659 ((as instructed by our rep)) on a separate claim. Due to our specialty we cannot forego UAs and must find a solution. Our denial states, Provider Hold Flag Review.

We are also being told other providers are having this issue??

 

[erinal]

You're not alone

We have had the same issue. They will pay on our UDS codes but it is hit or miss. We too have to submit records for every single claim that has the UDS on there. Although we do not receive payment on each case, and we have a lot of them, we have received payment on some after submitting records. Here are some things we have figured out:

They want you to send the visit note, the order for the UDS, the screen, and the confirmation results

If you are sending all of those things listed above and still seeing denials then it is probably a problem with your providers documentation. Look up the BCBS medical policy for the urine drug screens and it will give you specifics on what they are looking for in regards to sufficient documentation.

I just noticed that you said you bill the G0659 on a separate claim..why don't you include it on the same claim as the office visit? Do you all use on onsite lab or do you send it to an outside lab?