I know that, but my question is UHC has denied every 64405 that we bill and won't give any specific info on this when I call for benes. At this point we're contemplating making all UHC patients cash for this service but would like to know if they cover it under any circumstances before doing so.
For example, Medicare has their LCD's which indicate which ICD-9 codes are approved for which CPT code. Having this information doesn't indicate that one should falsely code a claim or advocate such a thing, it does however let you know which services will be covered based on the patient's condition, which is all that I'm trying to find out for UHC.
Has anyone had any experience with this?? If the Medicare LCD shows that this service is considered Medically Necessary for neuralgia or migranes, then it gives us information that would be helpful when composing our appeal and if UHC won't cover this service regardless of the condition, we know not to accept the patient's insurance for this service.