AANEM News Express

AANEM News Express

AANEM Succeeds in Changing BCBS-MA’s Medical Policy

5/3/2017
 
In response to a request from AANEM, BlueCross BlueShield of Massachusetts (BCBS-MA) announced a revised policy to incorporate symptom-based ICD-10 diagnosis codes. 

The AANEM office had been contacted by multiple physician members in past months about denial issues revolving around reimbursement for needle EMG and NCS testing in those patients with normal test results. These patients are typically billed utilizing symptom codes such as numbness, tingling or pain. Numerous providers had been receiving denials for these types of patients, because the BCBS-MA policy for Electromyography and Nerve Conduction Studies did not contain symptom-based diagnosis codes as medically necessary for electrodiagnostic testing.

AANEM staff worked with physicians to develop appeal letters for use in denials, as well as establishing contacts within BlueCross BlueShield of Massachusetts in order to directly address this issue. The AANEM office received notification on Tuesday, May 2, 2017, that BCBS-MA had added symptoms to their list of medically necessary diagnosis codes, making it possible for physicians to be reimbursed. “This is an important change for AANEM members. We are happy that BSBS agreed to make AANEM’s suggested changes and that we can help our members receive appropriate reimbursement for the work they do,” said Carrie Winter, AANEM Health Policy Manager.

If you have any coding and billing questions or concerns, please contact the AANEM policy staff at policy@aanem.org


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