Author Topic: Chiro and Xray  (Read 896 times)

Billing2

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Chiro and Xray
« on: April 18, 2016, 12:37:17 PM »
My provider has asked me to research x-ray codes. We are an out of network provider.

We use to Bill code 72010 prior of 2016. In 2016 they deleted that code and changed it to 72082.  Before 2015 we got $240.00 for the 72010. Once they deleted that code and we have to use 72082 our rate now is $ 140.00. They stated per the RVU for that code that is the new rate.
Has anybody else ran into this or is it just are Horizon Blue Cross Blue Shield of New Jersey? 

We could bill out each view, like 72050,72110,72080.

I wish they had a code for cervicalthoric AP/LAT. But they don't. The have lumbarsacral AP/LAT. Because that is really what we do.

Thank you for your help.

Michele

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Re: Chiro and Xray
« Reply #1 on: April 19, 2016, 08:09:48 AM »
I don't have any specific experience with Horizon BCBS or those particular codes but I have seen our local BCBS change the cpt code that they allow to a different one for the same service that had a much lower allowable amount.  It is frustrating.  The provider's costs didn't change for providing the service but they suddenly have to take a lower reimbursement.  But unfortunately there was nothing we could do.  The provider ended up not providing that service anymore and referring the patient out.   It was an in office lab so now the patient has to go to an outside lab.  It's not as effective since the provider doesn't get an immediate result while the patient is in the office.   I don't have any suggestions for you.  :(
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