Medical Billing Forum

Payments => Insurance Payments => : catooch December 23, 2008, 03:22:58 PM

: denial from UHC
: catooch December 23, 2008, 03:22:58 PM

Hi Michele,

I'm in a small chiro office and I just received a denial for a patient that we received authorization on.  When we sent out the claim it got denied because they said it didn't support the info that we send.  The only thing I can think of is the pt came in with the usual lumbar pain but also presented with a sprained ankle which was shown on the auth paperwork.

Nowhere on our claim did we refer tto this ankle sprain.  Is that why they denied? If so, is there a modifier or some other codes we should have used.?

We billed 847.2, 739.3, 728.85, 724.2 with 99214, 97535, 98941, G0283, 97010.

Thanks, Cathy

: Re: denial from UHC
: Michele December 23, 2008, 04:29:18 PM

You shouldn't have to indicate the ankle since DC's aren't suppose to treat extremities anyway.  It sounds more like they are looking for notes/documentation.  Even though you received authorization, they may request notes.  I would try calling to see what exactly they are looking for.

Michele

: Re: denial from UHC
: catooch December 26, 2008, 02:03:18 AM

Thank you Michele for quick response.  Happy Holidays............

: Re: denial from UHC
: Michele December 27, 2008, 09:59:37 AM

Thanks!  :)  I'm enjoying them so far.

Michele