Medical Billing Forum

Billing => Billing => : DaveMoody March 07, 2016, 09:03:40 PM

: United Healthcare Commercial keeps denying preventive code coded with vaccines
: DaveMoody March 07, 2016, 09:03:40 PM

I don't know what the deal with United healthcare is, I recently discovered that anytime I code a preventive visit with vaccines, they'll deny the preventive code and pay for the vaccines.

I called United healthcare commercial about this and they told me anytime I code a preventive code with vaccines, a modifier has to be appended to the preventive visit. Of course I didn't bother to ask what that modifier might be because I had a feeling they wouldn't tell me.

Is there anyone who is familiar with the billing/coding policy for United commercial? Could you please tell me what modifier I'm supposed to append to a preventive code while coding it with vaccines? I would greatly appreciate it.

: Re: United Healthcare Commercial keeps denying preventive code coded with vaccines
: Michele March 08, 2016, 02:16:52 PM

Take a look at modifier 25.  If the patient's notes indicate that the preventative visit was separate from the vaccine then the 25 modifier may be appropriate.