Wiki Modifier 52 or 53.

[cmeister35]

UHC Medicaid is denying the discontinued modifiers 52 and 53. any suggestings?

 

[trarut]

Can you provide more information about the denials. What denial reason are they giving?

 

[cmeister35]

UHC is stating that they do not recognize either of these modifiers for a discontinued procedure.

 

[trarut]

Interesting. Unfortunately, I think you're going to have to call or send an inquiry via the website, if you have access. The UHC Community Plan reimbursement policy for discontinued procedures shows Kentucky is exempt and 53 modifier is not reimbursable but it does not indicate how to submit those services for appropriate payment. Here's a link [Click Me]to the policy I found online. Probably not helpful and hopefully someone else from Kentucky will chime in. I'm in Ohio which isn't subject to the exemption; the most we've had to do was submit records to support the discontinued procedure.