Author Topic: BCBS denial codes  (Read 72 times)

Chiro Billing Collect

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BCBS denial codes
« on: November 18, 2020, 02:45:13 PM »
Re: Chiropractic billing

BCBS just recently started denying modalities (mainly 97012 and 97140) stating that: QJB - We cannot pay for this service due to a contractual agreement with the provider for this procedure and B15 - This service/procedure requires that a qualifying service/procedure be received and covered.

These are services that were always payable under the provider's contract and now about 85% of the claims come back with those denial codes for the modalities.

I was wondering if anyone had any insight? I thought they may have recently started to require the GP modifiers as UHC does but I am at a loss.

Thank you in advance.

Michele

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Re: BCBS denial codes
« Reply #1 on: November 22, 2020, 06:15:12 PM »
Is it all BC plans across the board?  Or just Medicare Advantage plans?  Have you called and spoke to anyone?  I would start with my provider rep, if you have one.  They should be able to point you to a bulletin, or something to explain the sudden denials.
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