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Incorrect Denials for CPT Codes 99000 and 99051

We have recently identified a system configuration error that caused the lab handling and collection fee (CPT code 99000) to deny as incidental or mutually exclusive (ZI/ZX) when filed with an E&M code (i.e., CPT code 99213) on claims processed between July 13, 2013, and August 9, 2013.  In addition, CPT codes 99001 and 99002 may have also denied incorrectly as a result of this system error. 

Impacted claims are being reviewed and will be reprocessed if they were denied incorrectly, so please do not submit claims to be adjusted or request adjustments.  Claims processed after August 9, 2013, will receive a hold code and suspend until a system fix can be implemented. 

In addition, CPT code 99051 (“services provided during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service") denied incorrectly with a ZX (MUTUALLY EXCLUSIVE PROCEDURE) when reported with an office visit (place of service 11) for the same claims processing period as indicated above.

If you have any questions, please contact the Provider Blue LineSM at 1.800.214.4844.