denied pc due to being considered an Incidental pc

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Erica Johnson

• October 10, 2019 20:10

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

  • October 11, 2019 17:47

  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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  Yolanda Winfield

  • October 11, 2019 18:16

  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

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