01/15/2020

Fidelis Denials for CPT Codes 29540 and 29550

About Nov 2019 Fidelis started to deny strapping codes cpt 29540 and 29550. We appealed. Etc. still denied My billing co called Fidelis. They were told these codes were removed by Medicaid and thus they no longer exist under Fidelis and will not be paid. Anybody have any suggestions. Comments.

Reviewing the Medicaid fee schedule for late 2019, the information received by the billing company is accurate. FFS Medicaid will not cover most strappings for podiatrists with the exception of unna boots. While Managed Care plans can cover services that are not traditionally covered by the state, they are allowed to exclude services if it is not on the fee schedule for the specialty. Unfortunately, there is no recourse unless Fidelis Care decides to cover the service at a later time, or if the CPT codes (29540 & 29550) are reinstated by the DOH as a covered procedure for podiatry.