Author Topic: BCBS DME Bilateral Billing  (Read 400 times)

mandaree23

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BCBS DME Bilateral Billing
« on: January 17, 2018, 10:44:32 AM »
I am working some old appeals and need some help on billing to BCBS.  It appears that the claims were being billed to BCBS for L1907 and L1970.  Our previous billing company was sending them on one line item with RT and LT modifiers and 2 units.  They are only paying one unit with remark code N640 "Exceeds number/frequency approved/allowed within time frame."  Does anyone have any suggestions on billing these?

Thank you

kristin

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Re: BCBS DME Bilateral Billing
« Reply #1 on: January 17, 2018, 07:24:56 PM »
I would bill as follows:

L1907 LT
L1907 RT

L1970 LT
L1970 RT

Your particular BCBS may require KX modifiers, in which case they would go on each line before the LT and RT modifiers. Also keep in mind that they may have a MUE of 1 for these codes, in which case you can't bill more than one on a particular DOS...but that is usually not the case with these codes. Some patients do require them for both ankles/feet at once.