Wiki Uro studies

[willoughbyclan]

I'm billing a Uro study with the codes below. A KY Medicaid managed care plan is paying all the codes but the 51729. The denial reason states "unable to determine coverage without appropriate modifier".

51729
51797-51
51784-51
51741-51
51798-51

Any idea what they may be wanting?

Thanks so much!

 

[jflynn124]

Billing/Collections Rep

It could be because proc 51797 doesn't need mod 51 & by adding it, it implies that there is another primary proc. We bill 51797, 51728, 51784-51 and 51741-51 and of course a ua. We also do not bill the 51798. Hope this is helpful.

 

[michelleaapc2012]

I agree with jflynn124, but I did have UHC deny 51797 because the patient was in the global period for a sling (57288) and I didn't use a modifier.