fidelis claims denied

[Tayyaba Arif]

3 CPT code are billed together for insurance FIDELIS.( CPT: J2796 , 96372 ,99211) fidelis paid only 2 cpt for payment (J2796 , 96372) it always denied CPT : 99211 with denial reason code "denied due to Benefit for service included in pymt for another svc that was adjudica"
so that how we can get payment from fiedlis for this cpt : 99211.

[kristin]

It depends. If the only thing done was the injection, even if vitals were taken, then all that should have been billed was the 96372 and the J2796.  If something else was addressed beyond the injection with the patient, then the 99211 needs a 25 modifier. Be prepared to have to submit the note, because insurances are cracking down on 99211 when submitted with injections, since it often should not be billed at the same time.