denied pc due to being considered an Incidental pc
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i am trying to bill pc 90832 & BCBS is saying that pc is denied due to being an incidental procedure code & is included in the 90791. Does anyone know how to bill or know what the modifier would be in order to get paid for the additional 30 minutes?

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    Gillian

    Hi Erica, we'd recommend reaching out to the payer directly regarding this denial and their billing guidelines, as different payers have different rules regarding CPT code usage on claims.

    Hi Erica, we'd recommend reaching out to the payer directly regarding this denial and their billing guidelines, as different payers have different rules regarding CPT code usage on claims.

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    TPC Admin

    Just a suggestion....

    Codes 99354-99355 are reported in the office or other outpatient setting when a provider performs prolonged service(s) involving direct patient contact provided beyond the usual E/M or psychotherapy service

    Just a suggestion....

    Codes 99354-99355 are reported in the office or other outpatient setting when a provider performs prolonged service(s) involving direct patient contact provided beyond the usual E/M or psychotherapy service