Sep 23rd, 2013 - kte950363
Protein C Deficiency Profile
We had a patient whose sister was just diagnosed with the deficiency, and patient wanted to be checked. We collected and sent to lab for testing, using V18.3 as dx code. BCBS denied, stating non-covered procedure/screening when done in conjunction with a routine exam. The patient was billed $365 for the profile. Is there anything else we can do to get BCBS to pay? Thanks
Sep 23rd, 2013 - nmaguire 2,606
re: Protein C Deficiency Profile
Probably not, BC/BS considers screening (which it is) and can make their own policies based on coverage plans.