Author Topic: denial from UHC  (Read 1955 times)

catooch

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denial from UHC
« on: December 23, 2008, 12:22:58 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

Michele

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Re: denial from UHC
« Reply #1 on: December 23, 2008, 01:29:18 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
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catooch

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Re: denial from UHC
« Reply #2 on: December 25, 2008, 11:03:18 PM »
Thank you Michele for quick response.  Happy Holidays............

Michele

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Re: denial from UHC
« Reply #3 on: December 27, 2008, 06:59:37 AM »
Thanks!  :)  I'm enjoying them so far.

Michele
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