Well child denial?

pedihc

Networker
Messages
27
Location
Lewiston, ME
Best answers
0
We received a denial from Anthem regarding a well child visit. Stating that the procedure code was not listed on their fee schedule? Of course they did not let us know which procedure code it was and I have replied with that question, but I wasn't sure if someone on here would possibly know the answer. What we billed is...
99395-z00.00
80061-z13.220
36416-z13.220
96160-z00.00
90715-z23
90471-z23
90620-z23
90472z-23
 

SharonCollachi

True Blue
Messages
1,761
Location
Clovis, CA
Best answers
3
In the Anthem Blue Cross of California Fee schedule, 90620 shows in the notes section: "Err-Procedure Suspend Exists".

90472 shows in the notes section: "AIS-AS-IS SURGERY".

They all have dollar amounts associated. I'm guessing it's the 90620.
 

wlf78911

New
Messages
7
Location
Sacramento, CA
Best answers
0
We received a denial from Anthem regarding a well child visit. Stating that the procedure code was not listed on their fee schedule? Of course they did not let us know which procedure code it was and I have replied with that question, but I wasn't sure if someone on here would possibly know the answer. What we billed is...
99395-z00.00
80061-z13.220
36416-z13.220
96160-z00.00
90715-z23
90471-z23
90620-z23
90472z-23
I am guessing CPT code 99395 needs a modifier
 
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