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Claim Rejected. Insurance has been filed for years for this client and its claiming the CPT code is incorrect, yet that has been used for years.



  • Kim Sullivan

    Did your payer recently switch to using the Availity portal?  I had a similar problem with one Magellan Medicaid plan that switched - previously I had no problems using the SP billing function, but after the switch I found that I had to go in to Availity and manually enter my claim.  I never was able to find out why this occurred, but hopefully it will help you get paid.  On a side note, I had to contact my payer multiple times before I received payment for those rejected claims.  Hope your process is quicker!

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  • Estella Sickle

    We work out of network, but file insurance for clients to make it easier for them to receive their reimbursement. We had this issue present itself years ago and were told this was the correct Code to file for this specific client/situation. Beginning this year, all of their Claims have been declined. I will look into the Availity and check with the client. Thank you.

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  • Tara Joiner

    I think something changed as of January 1, 2023. I had add-on code 99354 accepted for client in December and rejected in January for the same client. And I’ve read Tricare stopped using this code as of this year also. Idk what to do though or where to find the official ruling from BCBS.

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  • Dr. Melinda L. Bloos

    Tara Joiner - the CMS and AMA have done away with the 99354 code. In 2012 when there were code changes they did away with the 90” psychotherapy code & after a bit of time w no code, we were given this one to use. As of right now there is no code being offered. I’m concerned there may not be one offered, we’ll see. 

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