Wiki Bundling of UA

[amyrepp]

Has anyone else been denied by Health Alliance Plan (or other insurance companies) stating that the UA (81002) is being combined with the physical codes? HAP states that it is part of the CCI edits and should have been this way for some time. Any input would be appreciated. Thank you

Amy
Pediatric Consultants of Troy
Troy, MI

 

[LADY_SETSUNA_CJ]

Good Afternoon,

Yes I've also been getting denials on the 81002. We have billed various insurance companies and I have never been able to get this procedure paid. The encoder program we have says that this is not a bundled code and can be billed with an office visit, however, I've had no luck thus far. It does say Medicare considers this code a 'Statutory Exclusion.'

I know this doesn't help much but I just thought I'd let you know you're not alone.

___________________

Cheryl Miles, CPC

 

[cmcgarry]

Although most encoder programs don't show a non-microscopic UA as bundled, some claims editing software used by the insurance companies does bundle these into the office visits. If I remember correctly from when I worked at the insurance company, the rationale was that a "dip" only UA work would be included in the work/allowance for an E/M. Some insurance companies do this, others don't. I've not had any luck appealing these.