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Wiki Prolonged service 99358-99359 denials

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courtneymathis

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Is anyone else getting denials from Medicare MCO carriers for non-face-to-face prolonged services 99358-99359? The impression is that carriers should follow medicare guidelines but some aren't (mostly Aetna and BCBS) and they are denying these claims. Has anyone else experienced this and found a solution? Thank you!!
 
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courtneymathis said:
Is anyone else getting denials from Medicare MCO carriers for non-face-to-face prolonged services 99358-99359? The impression is that carriers should follow medicare guidelines but some aren't (mostly Aetna and BCBS) and they are denying these claims. Has anyone else experienced this and found a solution? Thank you!!
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We haven’t had this denial, but I recall reading that medicare was no longer covering those codes as of 1/1/21.
 
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