Medical Billing Forum

Billing => Billing => : Anastajia February 09, 2018, 10:34:11 PM

: DBT Billing
: Anastajia February 09, 2018, 10:34:11 PM

Hi

Anyone out there bill BCBS for DBT provider LCSW

Using Codes 98037 TG with modifier XE plus
                   90853TG

BCBS not paying now saying not in the correct billing protocol with the modifier, always billed it this way and gotten paid .
Do not know what changed called BCBS and of course the wont tell us.

Thanks

: Re: DBT Billing
: Michele February 14, 2018, 10:04:13 AM

Do you have a BCBS Provider rep? They should be able to tell you if something has changed.  At the least point you to documentation.  I know they are not allowed to tell you how to code but if something was paid previously but is not being paid now they should have an explanation.  I bill for several LCSWs but we have not used the modifiers TG or XE.

: Re: DBT Billing
: Anastajia February 19, 2018, 03:34:55 PM

Michelle

Thank you, yes we have a BCBS rep and we contacted her, but of course they would not give us any guidance.

: Re: DBT Billing
: Michele February 26, 2018, 04:40:31 PM

Our provider reps are very helpful.  That's their job.  Do the services require pre auth?  If they are authorized then maybe they do not need the modifiers.  90837 and 90853 are by definition obviously separate services.  Just wondering if you billed it without the modifiers if that would work.