MI – Claim Not Covered – Diagnosis Code F419

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Age: 31, Zip Code 48840, Income: approximately 96k household

My core inquiry is if this is worth disputing. Health care information: Blue Cross Blue Shield of Michigan – HSA – deductible then co-insurance, deductible not yet met.

Current medical conditions: Anxiety and ADHD – both medicated.

I was reading one night a month or so ago and the side of my face went numb and my arm got tingly, it only lasted a few minutes but it didn’t help my anxiety, I freaked out, called my wife to come home and we decided what to do. Thinking I had an idea of what may be happening, I consulted the internet and specifically the CDC web site listed below:

https://www.cdc.gov/stroke/signs_symptoms.htm

https://www.cdc.gov/stroke/types_of_stroke.htm

The first article lead me to the second and specifically a Transient Ischemic Attack (TIA) – some symptoms of which I’d just experienced for a duration of time listed as possible or common.

As a result, I followed the CDC web site suggestion and called an ambulance, they did the stroke testing on me there and at the hospital – both negative. Per the diagnosis code F419 it was deemed related to my anxiety and I was released that night.

Should I contest this lack of coverage?

Denial reason + some info from insurer web site:

“EMERGENCY DEPARTMENT VISIT, MODERATELY SEVERE PROBLEMDiagnosis: F419 Procedure: 99283Explanation Message: THIS SERVICE ISN’T PAYABLE BECAUSE IT WAS NOT FOR A MEDICAL EMERGENCY, A CONDITION THAT OCCURS SUDDENLY AND UNEXPECTEDLY AND COULD CAUSE SERIOUS BODILY HARM OR THREATEN LIFE IF NOT TREATED IMMEDIATELY. IF YOU DISAGREE WITH THIS DECISION AND WANT US TO RECONSIDER YOUR CLAIM, PLEASE CALL THE CUSTOMER SEVICE TELEPHONE NUMBER ON PAGE 1 OF THIS STATEMENT (TOP RIGHT CORNER). (M744) “

submitted by /u/TehSakaarson
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Age: 31, Zip Code 48840, Income: approximately 96k household My core inquiry is if this is worth disputing. Health care information: Blue Cross Blue Shield of Michigan – HSA – deductible then co-insurance, deductible not yet met. Current medical conditions: Anxiety and ADHD – both medicated. I was reading one night a month or so ago and the side of my face went numb and my arm got tingly, it only lasted a few minutes but it didn’t help my anxiety, I freaked out, called my wife to come home and we decided what to do. Thinking I had an idea of what may be happening, I consulted the internet and specifically the CDC web site listed below: https://www.cdc.gov/stroke/signs_symptoms.htm https://www.cdc.gov/stroke/types_of_stroke.htm The first article lead me to the second and specifically a Transient Ischemic Attack (TIA) – some symptoms of which I’d just experienced for a duration of time listed as possible or common. As a result, I followed the CDC web site suggestion and called an ambulance, they did the stroke testing on me there and at the hospital – both negative. Per the diagnosis code F419 it was deemed related to my anxiety and I was released that night. Should I contest this lack of coverage? Denial reason + some info from insurer web site: “EMERGENCY DEPARTMENT VISIT, MODERATELY SEVERE PROBLEMDiagnosis: F419 Procedure: 99283Explanation Message: THIS SERVICE ISN’T PAYABLE BECAUSE IT WAS NOT FOR A MEDICAL EMERGENCY, A CONDITION THAT OCCURS SUDDENLY AND UNEXPECTEDLY AND COULD CAUSE SERIOUS BODILY HARM OR THREATEN LIFE IF NOT TREATED IMMEDIATELY. IF YOU DISAGREE WITH THIS DECISION AND WANT US TO RECONSIDER YOUR CLAIM, PLEASE CALL THE CUSTOMER SEVICE TELEPHONE NUMBER ON PAGE 1 OF THIS STATEMENT (TOP RIGHT CORNER). (M744) ”
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