Our daughters have been refered by their pedetrician for genetic counseling due to suspected connective tissue disorder (ehlers donlas) at UNC in North Carolina. We have BCBS (blue home). I am trying to find out if we need pre-approval for this first time vusit/ consultation (I know that for the actual blood work and tests we will need). BCBS will not tell me if I need pre approval without giving them the cpt code. They don’t even have a general answer if genetic clinic needs pre approval or not. The provider that is doing the consultation claims she has no idea what the code is. She gave me a 99205 cpt code which I understand is a general specialist office visit code, but does not refer specifically to genetics. UNC claims that only the NP that does the actual visit can give the code, but again she claims not to know.. The pedetrician’s office also says they have no codes on the referal, and that I would only have to pay the co-pay for the 99205 visit… Does any one have any idea who I should be asking for at UNC to find these codes??? Can the NP in genetucs that ptivides tge consultation really not know the code for services (I know she can’t tell me cost or coverage)? UNC finance and billing are not helping. Does any one here have any idea how much genetic consultation could cost (even a ball park estimate) if we were to be stuck with the bill because the consultation was not pre approved? I will add that I have been most of my afult life out of the US in a country with socialized medecine, so I am learning the whole mess of the American health system. We are Ametican citizens and have come for diagnosis and treatment options due to the fact that it is hard to find experts in our country for my daughters’. We may consuder paying OOP, but we need to at least get an estimate first to find out where we stand finance wise. Thanks!
submitted by /u/Blley
[link] [comments]Our daughters have been refered by their pedetrician for genetic counseling due to suspected connective tissue disorder (ehlers donlas) at UNC in North Carolina. We have BCBS (blue home). I am trying to find out if we need pre-approval for this first time vusit/ consultation (I know that for the actual blood work and tests we will need). BCBS will not tell me if I need pre approval without giving them the cpt code. They don’t even have a general answer if genetic clinic needs pre approval or not. The provider that is doing the consultation claims she has no idea what the code is. She gave me a 99205 cpt code which I understand is a general specialist office visit code, but does not refer specifically to genetics. UNC claims that only the NP that does the actual visit can give the code, but again she claims not to know.. The pedetrician’s office also says they have no codes on the referal, and that I would only have to pay the co-pay for the 99205 visit… Does any one have any idea who I should be asking for at UNC to find these codes??? Can the NP in genetucs that ptivides tge consultation really not know the code for services (I know she can’t tell me cost or coverage)? UNC finance and billing are not helping. Does any one here have any idea how much genetic consultation could cost (even a ball park estimate) if we were to be stuck with the bill because the consultation was not pre approved? I will add that I have been most of my afult life out of the US in a country with socialized medecine, so I am learning the whole mess of the American health system. We are Ametican citizens and have come for diagnosis and treatment options due to the fact that it is hard to find experts in our country for my daughters’. We may consuder paying OOP, but we need to at least get an estimate first to find out where we stand finance wise. Thanks! submitted by /u/Blley [link] [comments]Read Morer/HealthInsurance