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initial hospital 99223

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PMBS:
I have been getting a lot of denials from BCBS on cpt 99223.  My doctor is the admitting physician and it seems like the consulting physician is also billing the same CPT code.  Is anyone else having the same problem and what have you been doing to get it paid.  I have appealed it with BCBS and they denied my appeal. 

Any help will be greatly appreciated.

Thank you

Miriam

kristin:
Are you using the AI modifer? It used to be just for Medicare, but many BCBS carriers require it also, as well as other commercial insurances.

PMRNC:
If your provider is the principal physician of record they can bill using the modifier AI.

 

PMBS:
Thank you.  Yes, I have started using the AI modifier.  I have even sent in a corrected claim and appealed it and BCBS still denies the claim.  My physician is the principle physician too. 

Michele:
Do you have a provider rep?  They are usually very helpful.

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