Wiki UHC Denials for UTiD

[prakashkg]

We are getting denials from UHC/Wellmed insurance stating that CO-96 - Non-covered charge(s). At least one Remark Code must be provided, N35 - Program integrity/utilization review decision,
these are the billing CPT codes 87798,87481,87556,87640,87653,87651,87563,87086.
We have tried with single CPT 87801 also but still getting the same denial. Please anybody help on this

 

[TThivierge]

Prakashkg
What is the medical reason or dx code given by provider wanting lab tests? Did you bill it with infection and where found first or just Z dx code first? This info here might help you related to lab codes....
CPT 87556 TB see dx blocks A15, A18 and Z dx appropriate code last CPT 87640-87641 Strep Aur infection see dx B95.1 or B95.6 blocks, CPT 87653-87651 see dx blocks B95.0-B95.1
CPT 87086 Urine see dx N28.89 or illness where urine is checked DM or HTN or CHKD or sex diseases
I hope helped you somewhat.
Lady T