Wiki United Healthcare Denial

[TiffanyM101]

Has anyone been having trouble getting paid on bilateral drugs from UHC? They keep denying for inappropriate use of modifier. When I call them they tell me to follow CMS guidelines which I am. I'm not sure how they want those coded, if anyone has some insight on how to get paid I would appreciate that.

 

[ssirsky]

Not sure how it differs between specialties and different drugs, but we do bilateral eye injections and UHC started only paying if we submit them on one line with the JZ modifier and no laterality modifiers. Before we'd submit, for example, J0178-RT and J0178-LT two lines, now they want J0178-JZ with the units doubled.