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pregrnancy tests- cpt 81025

C

CCori

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7
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Arnold, MO
I was just told by UHC Comm (Medicaid) plan that as of the end of May 2017, any code in the 8000 series thru 8900 now need a modifier? Has anyone heard of this? and what modifier are you using?
Thanks!!
Cindy
 
CCori said:
I was just told by UHC Comm (Medicaid) plan that as of the end of May 2017, any code in the 8000 series thru 8900 now need a modifier? Has anyone heard of this? and what modifier are you using?
Thanks!!
Cindy
Click to expand...

This is something that is specific to your state's Medicaid. Each state's Medicaid has jurisdiction over certain coding requirements separate from CMS. You would need to ask UHC Comm for a list of appropriate modifiers and their requirements for usage. They probably sent out an announcement about this prior to implementation. They may have a state level HCPCS modifier they are utilizing or it may be certain existing modifiers such as ET for emergency services, EY for no physician or other licensed health care provider order for this item or service, or KX "requirements specified in the medical policy have been met" or it could be the CMS modifier QW that this is a CLIA waived test.

Too many possibilities to speculate.

Karen
CCS-P, CPC, CPB, CPMA, CPC-I
 
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