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Wiki 90853 Denials for SUD and MH Possible Modifier Issue?

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BillingWest1

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I wanted to see if anyone has successfully billed 90853 to UHC and received reimbursement on services? I bill for OP substance abuse facilities and have been stopped up in denials over this and I have tried all sorts of modifiers to get these claims paid. The denial reason now comes as B20 - "B20 - Procedure/service was partially or fully furnished by another provider." I'm not sure what this means and UHC has not given any clarification onto the matter. I am billing this on a Professional with POS 57 and TOS 9. Please advise...thanks so much!
 
That denial means someone else already billed it. Are you billing for the provider or for the facility? Have you checked to see if the mental health portion of the plan is carved out to someone other than UHC? Have you checked to see if UHC pays facility fees for an outpatient facility? I have seen some plans that won't pay for outpatient facility fees for mental health, you have to bill it as pos 11 (professional fees only).
 
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