BCBS denying hypogastric plexus block

[Doctodd]

as title says, they are denying 64517 hypogastric plexus block for an incorrect diagnosis code interstitial cystitis 595.1 .......any help appreciated.

Heard from an attorney at the FMA conference that BCBS is so big they think they are the government.

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[Jcm800]

as title says, they are denying 64517 hypogastric plexus block for an incorrect diagnosis code interstitial cystitis 595.1 .......any help appreciated.

Heard from an attorney at the FMA conference that BCBS is so big they think they are the government.

i have nothing constructive, but are you really doing hypogastric block of IC? Is it working for you? i gave up on anything pelvic pain related... never had a patient respond

with every post it seems like i do less and less each day...


but that being said, just call it Pelvic pain. 625.9

that worked for me, but it was like 2 years since i needed it...

 

[Doctodd]

i havent seen her back after that one block a couple months ago......i had my office call her and she said it helped. Her regimen before i saw her was some ridiculous number of percocet each day(10-12) so it was tough to say she could get any worse, only better.

I shall try that code thx.

 

[PMR 4 MSK]

BCBS has gotten so big, they have finally realized their power - pay their administrative doctors to review literature that does not support what we do, and use that as the basis to deny as much as possible. They are tightening the spigot now and will keep doing so.

They are in the business of making money, not paying it out, but they sell policies and contracts on the opposite premise. The patients and doctors often have no idea what will be paid or not until after the treatment has been rendered. Try doing that with your plumber.

My practice currently has somewhere in the region of 50-60 lawsuits filed against BCBS for illegal and predatory practices. Some are parts of class actions.

 

[drusso]

Call the medical director and talk about it. Or, *ping* their computers with a different code...

 

[Jcm800]

Call the medical director and talk about it. Or, *ping* their computers with a different code...

they are never available when i call...

 

[Tenesma]

how friendly are you with your hospital CEO - make the CEO go to bat for you with their CEO or CMO

 

[Mister Mxyzptlk]

I educate my patients about them & suggest they seek other coverage or speak with HR about changing insurance companies. If we all do that then maybe they won't be big for long.