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Blue Cross Blue Shield

Coding

Denials for the Combination of CPT 28306 with CPT 28122

by Dr. Michael Warshaw, DPM, CPC

“We have had more than one claim where Blue Cross Blue Shield of Oklahoma is paying for CPT 28122 but denying CPT 28306, despite the use of the 59 modifier. Our question is why wouldn’t CPT 28306 be allowed instead of CPT 28122 as it is far more work? We are trying to determine how to appeal this.”
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