Medical Billing Forum

Billing => Billing => : amanda@mountain-spine.com February 08, 2022, 06:33:54 PM

: Pain Management United Healthcare
: amanda@mountain-spine.com February 08, 2022, 06:33:54 PM
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.
: Re: Pain Management United Healthcare
: Michele February 10, 2022, 05:05:44 PM
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?
: Re: Pain Management United Healthcare
: rdmoore2003 March 22, 2022, 04:44:20 PM
Amanda, Is this for a facility or for the professional charge?