J100 with BCBS of LA

2bedaisy

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I am in billing for an urgent care group in Texas. However, many of our patients have Blue Cross and Blue Shield of Louisiana, and their plans invariably deny code J1100, even with -25 modifier appended to the E/M. Our local affiliate regards this as a payable code, and that is about all the information I can get from BC. Has anyone had experience with this, or have any ideas how we might get these paid?
 

mitchellde

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you need to give more information.. What are all the codes you are billing and how you linking the dx codes to the CPT and HCPCS codes
 

2bedaisy

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Almost exclusively, they are being billed with a 99214, 96372 and J1100, and the diagnosis is J01.90.

Thanks so much!
 
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