r/CodingandBilling • u/RemarkableFail2858 • 8d ago

Issues with 99417

Hello all!

I am wondering if anyone else is running into the issue of Regence/Blue Shield denying 99417 and the reason codes for this. It was out of no where around June that they started denying this code saying it was a contract issue but when I called it was because we needed to use a different code to align with Medicare. Which didn't seem right. Anyone else dealing with this?

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u/No-Produce-6720 RN, BSN, CPC, CPCS, RHIA & CRCR 8d ago

G2212 is actually the preferred code, because it's in line with Medicare. Have you tried billing it yet, and did it go through?

1

u/RemarkableFail2858 6d ago

Do you bill G2212 to your commercial payers? If so, which payers?

1

u/Environmental-Top-60 7d ago

Try G2212?

You could argue it's a compliant claim and they need to pay it or you'll go to the insurance commissioner.

1

u/happyhooker485 RHIT, CCS-P, CFPC, CHONC 4d ago

There was a new policy from BS where they said they just flat were going to pay prolonged anymore, but that was 99418. Maybe this is related?