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Wiki UHC Total hip and knee denials for invalid modifier

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jeskla

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UHC is denying all of our 27130's and 27447's as of 11-1 saying the "modifier is invalid." We code them with the LT or RT modifiers only. Anyone else having this issue? Did I miss a bulletin?
 
When I hear "denying all" Questions I would ask: is it really all of them? Does the diagnosis code match the RT/LT or is the laterality modifier/ICD possibly mismatched or not specified which side? Do you have a new total joint coder? Is it all of UHC or only a certain type? Is it possibly only the assistant at surgery and maybe someone is missing the 81/SA? How far has someone dove into the data?
 
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