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90853

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Jorden917:
Good afternoon

I am new to billing and to this forum so I have a couple of questions respecting 90853.  Our clinician is an LICDC II and this is my question:  If Medicaid allows and processes 2 units for 90853, why don't the MCP's that fall under the Medicaid umbrella allow and process same?  I tried billing for 2 units and it came back denied indicating "claim exceeds the number of allowable units for this procedure".  I even tried using the modifier of 76, and U3.  How can I bill for 2 units?

Michele:
I have never seen an insurance carrier allow more than one unit for the 90853.  What state are you in?  I would try first contacting the MCP and make sure it wasn't a processing error.  You may be able to contact the state dept of health to ask if the MCP has to follow the same services.

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