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Wiki Blue Cross Med Nec

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dmonty

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Ballston Spa, NY
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What are you guys doing about Blue Cross denying for med nec because the primary dx is not the covered dx? It's like they want you to code against coding guidelines in order for the claims to pay. Or if there are multiple services done, like a CT scan on 2 different areas, they will only pay whichever one has the primary dx code. I've tried appealing because the covered dx code is on the claim, just not primary and they still deny stating it needs to be primary.
 
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