Insurance Denied STD Tests

A couple of months ago I went to my obgyn and got tested for STDs while I was there.

I got a $600 bill from the labs for the testing and I was floored!! I had tests done last year and it was covered, no charges at all.

I called my insurance (BCBS) and they said it’s not covered because it’s “preventive” and not diagnostic. WTF? I asked if it was coded on my claim from the labs differently would it change the charges. The customer service rep said potentially but cannot make any recommendations to the provider. I told her that I had been covered before, and these tests are required to be covered by the ACA, and she just kept saying the same thing.

I looked at both claim statements from this year and last year and the only difference is one says wellness and the other says pathology for each test.

For example, for chlamydia tests, the claim for the tests I did last year says: 87491-lab-pathology

The claim for the recent tests I had say: 87491-lab-wellness

On my insurance summary of benefits it says diagnostic tests are 100% covered. So can one word (pathology vs wellness) really change how much I have to pay?

I’m going to call my doctor tomorrow and see if they can change that phrase and resubmit my claim. I’m afraid it will get denied again and be footed with a $600 bill.

Has anyone run into this before? Was there something you did that made them pay for your tests?? Seems outrageous they didn’t cover it this time when they covered it a year ago!