Blue Cross Blue Shield To Resume Payment for Pap Smears
At the end 2009 Blue Cross Blue Shield began denying payment for many cytopathology/pap smear codes due to implementation of a claims edit system aimed at detecting claims bundling, duplicate billing and other problems. Cytopathology/pap smear codes (88141-88155, 88164-88167, and 88174-88175) were denied when submitted with Evaluation and Management Services. Many OBGyn practices in Georgia were affected by the denials.
Blue Cross indicates that they will reinstate payment for those codes for a minimum of six months. Claims denied as a result of the edit will be reprocessed and paid. Re-filing of the denied claims is not necessary. And, in future, prior to reinstating the system that denies payment on pap smears, Blue Cross will provide 90 days notice of the change.
The Society plans to work with Blue Cross to discuss alternate ways of implementing claims editing so that pap smear payments will not be affected.
For additional questions please contact your local Blue Cross Blue Shield representative.
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