Per BCBS rep called and stated an claim should have been billed as an office visit to established not a wellness. However, this visit is coded 99384 for adolescent which states in the guidelines New Patient Initial Comprehensive Preventative. Is it required to bill a New Patient E&M visit first? Please advise.
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Wiki New Patient Initial Comprehensive
- Thread starter griffind3
- Start date
thomas7331
Guest
What is the service that was actually performed according to the medical record? That would determine what code need to be billed. An insurance company rep cannot tell you what should have been billed without having reviewed the documentation. Most reps are not coders and can't be counted on to tell you whether or not you have coded your claims correctly. I am always skeptical when they tell you how you should have billed. Best to call them back and talk to someone else and get more information.
SharonCollachi
Guest
I have a feeling a patient called and complained that their wellness visit was used by your office, when perhaps it was already used with someone else and was therefore not covered, and they're trying to get their claim covered. Did the claim pay?