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Pediatric Coding Alert

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Clarify Payer Guidelines to Avoid This Coding Headache

Published on Tue Nov 20, 2018

Question: We saw a patient on a Saturday morning during our regular Saturday hours for a preventive medicine service, but during the service, our provider diagnosed an acute migraine. We billed for a preventive visit along with a sick visit with modifier 25 and used 99501, but when we billed to UnitedHealthcare Rite Care (Rhode Island Medicaid), they denied payment [...]
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