Over the past several weeks, the Advocacy Council has received reports from various parts of the country that TRICARE has been denying claims for CPT Code 95165. We have investigated this, and it seems the erroneous denials were due to a computer software processing glitch or some other procedural problem that has now been corrected.
This past week, several practices have reported that they have been cleared and are now receiving back-payments. If you accept TRICARE, you may want to check to make sure your 95165 claims are being paid. If they are not, file an appeal.
As we have pointed out in a previous Insider article, if you feel you deserve to be paid for appropriately billed services, always file an appeal (even more than once if necessary) and contact your third party payer representative to express your concerns.
The Advocacy Council – we have you covered.