TB test follow up coded differently and was not covered by MinuteClinic-advice/help needed
I got a TB test that required two visits: one was the admnistration of the test and the follow up which was the reading. My insurance (blue cross blue shield) covers TB tests in general, so they covered the first visit. But CVS minute clinic coded the second visit as a separate generic follow up visit and did not house the two visits into the same TB test code, so my insurance did not cover the second visit. I went back and forth with my insurance and minute clinic, where my insurance placed a request for the code to be reviewed and minute clinic did review it, but rejected it saying that it was coded correctly.
My issue is that if minute clinic coded with the same code as the TB test first visit, then my test should’ve been covered. But they instead saw that it was a follow up visit (which it was but not really) and didn’t see the two visits were related. They are not willing to review it again, and my insurance will not process the follow up code as part of the TB test and cannot do anything unless the clinic sends them the code. I’m a little stuck and frustrated as I feel like there is no one left for me to explain that these two visits are related and should be covered, and it doesn’t make sense to cover the test but not the reading.
Is there anything I can do?
submitted by /u/sneksnaksnake
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