established office visits for pain management

NMURPHY8366

Networker
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30
Location
Louisville, Kentucky
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Hello. I started working for a pain management center and they are getting denials for established visit code 99213 from Anthem TEA, stating that its not medically necessary. Is anyone else in the pain management world having this issue? and if so, how have you gotten your claims to go through and paid?

Does anyone have suggestions as to where I can get answers from in regards to this question?
 
Last edited:
Messages
252
Location
Albany
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I have not come across this. Have you contacted the insurance? And if so what did they tell you?
If not, I would contact them and tell them this is an office visit. I am sure it is just an error.


Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
 
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