Which modifier should I use?

[Steve Verno]

five questions


(1)  Why did the patient visit your internal medicine physician

(2)  What diagnosis was used for each cpt code

(3)  is your provider contracted with United and if so, does the contract specify that the doctor agrees to United's coding policies?

(4)  Are all services billed, a covered service under the patient's health benefit plan?

(5)  Is the benefit plan under ERISA jurisdiction?

THis is not as simple as asking for a code or modifier!

[jcfenfen]

Hi,

I am billing for internal medicine doctor.  For a claim I billed CPT 99204, 90715 and 17110 on the same service date, and United only paid for 90715 and 17110 and stating that 99204 is included as part of the global service, and this charge is not eligible for separate reimbusement.  I called United Healthcare and they told me to bill with a code stating that 99204 is a separate service.  But what is that code or modifier?  Can anyone help? This is kind of urgent.  Thanks so much for any input