Question AARP/UHC DENIALS for spirometry/nebulizers

misstigris

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I have recently received denial from AARP and UHC on spirometry and nebulizers when they are billed with an OV and modifier 25. Some of the denials say due to bundling. some say not medically necessary even thou these have been paid in the past. I have looked on their sites and can't find anything. Is there a new policy out? Thanks in advance.
 

nrood

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What diagnosis codes are being attached to the spirometry and nebulizer treatment? I only had issues with medical necessity if diagnosis codes were incorrect- ie. J18.9. Are any other procedure codes being billed with those, other than the office visit with 25 mod? For example, if you bill a 94664 with either of those codes it will deny unless you have a 59 mod attached to the 94664.
 
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