Forum - Questions & Answers
Inclusive denials
Hi, Empire BCBS Healthplus CHP insurance always denying CPT 81003,81002 service charges inclusive with E&M service.
Please suggest me is there any BCBS reimbursement policies regarding this issue?
re: Inclusive denials
That denial is incorrect and has no logic, check your diagnosis code being reported, maybe it is throwing some type of error with their edits. I would contact Empire BCBS claims department, and if they can’t help you then contact your provider representative. There may be an error in their edits or a problem with a contract. The denial is not due to an NCCI edit or the test being inclusive with an E/M code.