Hi Tina, I have a bit of a mixed bag.  I had one BCBS plan pay $66.00 for 6 units, but most have denied as PR.  HP and Medica are denying all as PR.  Any idea why MA isn't approving?  That is odd, as it is their procedure in the first place.


We have only billed these codes to BCBS PMAP and so far none of them have paid. We had to contact a higher-up representative at Blue Cross to get any information on these. We were told that this was an error on the Blue Cross side where it was auto rejecting this code because of a modifier issue. They said they will reprocess all of our claims once they fix this issue. They originally claimed this would be fixed within 30 days but that was at the beginning of May and we follow up weekly but they are still claiming they have the error so they cannot resubmit yet.

Any flavor of BCBS is so slow at reprocessing, appeals, etc.  Very frustrating.


BCBS is the slowest at fixing or addressing any issue.  And they are very unapologetic about it to boot.

Does anyone have any more information on this subject? I have many H2027 services denied by BCBS PMAP as non-covered charges. Shouldn't they be covering these services as defined by the MHCP provider manual?

Thanks in advance!