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Texas BCBS Medicaid and DME

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mandaree23:
Happy New Year!  I am hoping someone can help me with some Medicaid challenges.  I bill orthotics and prosthetics in Texas.  I have several denials from our Texas BCBS Medicaid products stating to resubmit with Correct Benefit Code.  I know the Correct Benefit Codes vary depending on whether it's STAR vs STAR KIDS, if it's paper vs electronic and depending on the programs we are contracted with.

I have called the carrier and the rep was unable to answer and sent a message to their help-desk and I've yet to hear back.  Is there anyone that is familiar with this that can explain or point me in direction to find online. 

Thank you!!!

Michele:
I'm sorry but that is a very specific question for an issue that we have not experienced.  I personally would call the rep back and tell them you haven't heard yet. 

Sriram_Sub:
Please try accessing the provider manual from the URL below. The Index pages of these manuals have a section for "Benefit Codes" each. You can choose the appropriate one from the list and work with your billing software vendor and EDI Clearinghouse to have Box 11 of CMS1500 to report the correct Benefit code.

https://www.bcbstx.com/pdf/medicaid-star-chip-manual.pdf

https://www.bcbstx.com/pdf/provider-manual-starkids.pdf

Hope this helps.

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