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Guest
#1 Posted : Tuesday, May 25, 2021 1:53:41 PM(UTC)
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Guest

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Hello,
I have submitted my first professional claim to Anthem Blue Cross. They paid nothing and the explanation was "the medical procedure code is obsolete." I used 41899 CPT Code. Is 41899 CPT code obsolete for all medical insurances? Is it possible for one insurance carrier to give "obsolete" status to active codes?
courtneydsnow
#2 Posted : Thursday, May 27, 2021 8:02:35 AM(UTC)
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courtneydsnow

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Hi guest!

Hm yes the word "obsolete" is certainly an interesting term to use!
41899 is currently an active/valid CPT code, standing for: Unlisted procedure, dentoalveolar structures

It is possible for an insurer to decide they will not recognize a code/code set - for example, consultation visit code 99241-99245. That code set is technically still active, however Medicare decided to stop recognizing back around 2010, and since then some private/commercial insurers have followed suit and no longer accept them either.

However, i can't say i have seen this happen with code 41899 before!! It would definitely be worth an appeal if an appeal is allowed for the denial. Perhaps the insurer is simply looking for additional information/description on what service the code is being used to represent.

Question for you - did you use the "ZZ" qualifier on the line item to provide a short narrative description? Or was the explanation of what service the code is being used to represent provided in a narrative report that was submitted with the claim?
Guest
#3 Posted : Wednesday, June 9, 2021 5:02:41 PM(UTC)
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Hello Courtney,
Thank you for taking the time to answer my question. I did use "ZZ"; I submitted the claim using availity.com. I have submitted another claim with the same code for another patient with the same insurance company; this time they said: "codes are no longer valid". My patient called his insurance, and the insurance agent confirmed to my patient that the codes are correct!
courtneydsnow
#4 Posted : Monday, June 21, 2021 3:08:27 PM(UTC)
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courtneydsnow

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Well that's fun isn't it?!

If you haven't already, I would recommend sending in an appeal - one simple appeal may do the trick!
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