99072

[jenniferp]

Hello All --

I have seen a few posts/comments about 99072 and wanted to share what we've seen so far.  We just started using this code in December and other than being told straight away that Medicare wouldn't cover it, we have had a few responses from insurance companies.

BCBS said exceeds benefit max, Cigna denied as bundled with primary procedure and Humana denied straight out as non-covered, Bluecare (TN Medicaid plan) denied as bundled as well.  We haven't seen any denials yet on Tricare, Aetna or any of the smaller insurance plans.

Has anyone else seen any payments received any insurance response on that code?

Thanks -
Jennifer

[Michele]

We have not billed using that code, but we have an office that will be soon.  I also haven't seen any one that has billed it as well, or gotten any feedback. 

Anyone else billing that code?

[jenniferp]

Just an FYI on this 99072 code, we are going to stop billing it because none of the insurances we bill are paying it.  We knew Medicare and Humana didn't cover it, but evidently none of our other carriers are covering it as well.  The big ones we bill to are BCBS Tennessee, United Healthcare, Aetna, Cigna and Tenncare plans (Medicaid), but none of those are paying it.

[Kerri]

We have not billed it, as we checkeced first with Medicare, BCBS, Priority Health, Humana and Aetna (our main Insurances) and everyone said they would not pay it. BCBS infact told me that just because the government ok's a new code doesn't mean that the insurance has to to pay on it.   

[Michele]

BCBS infact told me that just because the government ok's a new code doesn't mean that the insurance has to to pay on it.   

Very true!