Q/A: Why is Code 99080 Being Denied when Billed with an E/M Service? Posted on March 21, 2018 at 03:13:30 pm To properly answer the question, it is important to first review the requirements of selecting the appropriate level of Evaluation and Management (E/M) service and how that relates to reporting a 99080 special report […]

Anthem Will Not Give Modifier 25 a Pay Cut Anthem’s original plan was to take a 50% reduction when providers reported claims using modifier 25, it was then lowered to a 25% reduction and has now been fully rescinded, to the relief of providers.  The policy was to go into effect March 1, 2018, however, due to […]

Increased Therapy Denials Create Administrative Burden Recently, many healthcare providers have begun to experience a downpour of denials when billing therapy services. The states which seem to be experiencing the most difficulty are Illinois, Oklahoma, and Texas, particularly for claims submitted to BCBS plans owned by Health Care Service Corporation (HCSC). Since HCSC also owns Blues plans in Montana […]