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Wiki Rapid Strep - 87880

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alk@APS

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HI All-

I'm new to Family practice billing and am having an issue with BCBS paying for rapid strep 87880 for adults? They are denying the claim as age inappropriate, I've tried finding a different code is 87561 more appropriate for an adult rapid strep test? Thanks for any additional help.
 
I have never had an issue billing 87880-QW for patients of any age

I would be very interested to hear what you find out after you contact BCBS

What dx are you using and what was the error code from the EOB?
 
Rapid Strep

I called BCBS and claim was put back for re-processing but the original decision to deny was upheld. The DX code was J02.0

"Procedure code is inconsistent with the patients age" (CO-6) This is the denial on the EOB

BCBS told me I could appeal but only if I included a letter from the patient giving me permission to appeal on their behalf - I have never heard of having to do that either!
 
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