12/03/2018

Billing UnitedHealthcare for 11721, 11042 & 11005 (Modifier 59)

what's wrong with that coding - they paid the two procedures with the 59 modifiers but not the major procedure

No payment has been made by United Healthcare because even though the modifiers are appended correctly, the Medicare advantage plan is requesting supporting documentation to show that the ulcer debridement was not related to the corn/callus removal. United Healthcare will reconsider the balance if a reconsideration request is sent along with the supporting documentation and a claim reconsideration request form (see the attached file).

Uhc Single Paper Claim Reconsideration Form