BCBS. 11055 + 11721 no longer work together.

[p100]

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Here is the message I received.

"As per BCBS new policy, when CPT 11055 and 11721 are billed together, only CPT code 11055 is eligible for reimbursement by the insurance."

Just another reason to find a new job outside of medicine.

 

[heybrother]

You are looking at this the wrong way. Usually when you get a fraudulent type denial like this (ie. Humana, Aetna, Scott & White) you are stuck appealing the claims and trying to fight it by yourself. You are the usual podiatry island in a sea of desperation wondering is it just you, is it everyone, are you doing something wrong etc.

If you truly received an email from BCBS saying that this is their policy you now definitively have something to send to the APMA to try and get them to fight it.

The APMA did successfully fight this off on Aetna though I assume Humana and all the others who deny are still at it.

 

[Feli]

I hear from another thread that you just bill 99215 in that sichyayeshun.

 

[deleted285117]

I hear from another thread that you just bill 99215 in that sichyayeshun.

Just gotta be sure you put in the note “60 minutes were taken to perform the patient’s pedicure.” 😜

 

[p100]

You are looking at this the wrong way. Usually when you get a fraudulent type denial like this (ie. Humana, Aetna, Scott & White) you are stuck appealing the claims and trying to fight it by yourself. You are the usual podiatry island in a sea of desperation wondering is it just you, is it everyone, are you doing something wrong etc.

If you truly received an email from BCBS saying that this is their policy you now definitively have something to send to the APMA to try and get them to fight it.

The APMA did successfully fight this off on Aetna though I assume Humana and all the others who deny are still at it.

Okay I see. This is one of their routine random denials. Good to know. I will update this thread if it turns into a routine thing from BCBS.