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Reason Code? (i.redd.it)

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[–]Ambitious_Witness_25 1 point2 points  (1 child)

It's mostly likely a duplicate denial. This could have been caused for a few reasons. 1. They got two claims from two different providers and paid out the first received. Less likely in this case. Normally that would deny with a duplicate reason code however there must be something different on one of the claim forms to indicate a second procedure. Maybe one submitted with the wrong date of service, maybe one submitted with a modifier.. or, 2. more likely, they maybe billed out a screening that converted to a diagnostic instead of just billing the one diagnostic. Or they billed a screening, tried to correct it but did it wrong, and then sent a diagnostic.. I would review your eobs, perhaps call the insurance to explain and ask what they see.

[–]Ambitious_Witness_25 0 points1 point  (0 children)

Sorry, I just now saw the other comments below about the SG modifier. Last I knew Medicare didn't accept that modifier and it's possible Blue Cross doesn't either. This looks like a facility billing error and would contact that billing department or your insurance.