Billing > Facility Billing

Help! BCBS of Fl is not paying for diagnostic EGD’s in a hospital outpatient

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NolesFan23:
Can someone help me?  I do billing in Florida for a GI group who does their Colonoscopy and EGDs in a outpatient hospital setting. I was told that BCBS would not cover the EGD’s anymore and wanted these patients to be seen at a surgery center instead.  If the patient was coming to our hospital for their colonoscopy screening and it we determined they needed a diagnostic EGD, we would have to send them elsewhere or is there an exception to the rule?  If anyone has any answers please let me know

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