Wiki Having hard time getting United Healthcare pay for CPT 90471 and 90686

[lataashwini23@gmail.com]

I work for Urgent care patient cam in just for flu short so we coded 90471 and 90686. United Healthcare denied for not covered when considered routine. Did i use the correct admin code or should i use modifier to admin code ?

Flu Vaccine given in left deltoid. 0.5ml using 22 1/2G needle. Patient tolerated well. LOT: 261983 EXP: JUNE302020 MP

 

[mahampton@hotmail.com]

You might call UHC to get more specifics. Is it a UHC MA plan? Has UHC opted in to a state vaccine program? Is this a grandfathered plan? Are those the only codes on the claim?

 

[jhendrix08]

What Dx code did you use? I'm assuming Z23? Your CPT codes are for sure not the problem. Did you try calling UHC to ask about this? I'm surprised it was denied for "considered routine" when it was a flu shot. It is possible that is was denied in error...I'd certainly call the insurance for an explanation.