Blue Plus and Testing

Melissa 7 years ago in Billing/Electronic Modules updated by Ashley Kallod 7 years ago 1

Recently for Blue Plus when billing out individual lines of 96101 they will pay on one line and deny the others saying it is duplicate.  I was told that I now have to use a modifier to bill these out? What modifier should I use? I am only having this issue recently with Blue Plus. 

Are you billing more than one code/service per date?  We don't do testing in my office, but my experience with Blue Plus (and BCBS MN in general) is that they will only pay for one service per day.  The only exception to this rule that I have found is that if the the second service is billed under a different diagnosis (for example:  we bill a group session under a substance use diagnosis and an individual therapy session under a mental health diagnosis).  We are currently sending some test claims with clients to see if they will pay for a UA on the same date as a group session; unfortunately we haven't gotten any useful feedback from the claims/customer service departments about a way we can bill more than service per day.