Medical Billing Forum
Coding => Coding => : Jorden917 March 26, 2018, 05:24:17 PM
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Good afternoon
I am new to billing and to this forum so I have a couple of questions respecting 90853. Our clinician is an LICDC II and this is my question: If Medicaid allows and processes 2 units for 90853, why don't the MCP's that fall under the Medicaid umbrella allow and process same? I tried billing for 2 units and it came back denied indicating "claim exceeds the number of allowable units for this procedure". I even tried using the modifier of 76, and U3. How can I bill for 2 units?
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I have never seen an insurance carrier allow more than one unit for the 90853. What state are you in? I would try first contacting the MCP and make sure it wasn't a processing error. You may be able to contact the state dept of health to ask if the MCP has to follow the same services.