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Pain Management United Healthcare

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amanda@mountain-spine.com:
Hi all,

Anyone on here do billing for pain management?  I am looking for some advise on United Healthcare.  How do you get 64633 and 64634 to pay without having to appeal.  They keep throwing Occipital Neuralgia guidelines at me (even if I change the diags), even though medical policy they used to and are supposed to be referring to is Ablative Treatments for Spinal Pain.  Is anyone else having this issue and what have you found that works?   Diags used : m43.02, m47.892, m47.812, m54.2, m50.10 (and m50.10 has worked the best but the appeals are agonizing!)  Thanks.

Michele:
Is it all UHC plans or one in particular?  It sounds like a plan guideline.  We bill for pain management and we didn't have issues with those codes.  The dx codes look fine, and no modifier should be needed for the addt level.  What specifically is the denial?

rdmoore2003:
Amanda, Is this for a facility or for the professional charge? 

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