UHC Unbundling EKGs (93000)

TheStephCode

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I would like to know if anyone else has encountered this situation and if so, how are you handling it?

When we bill 93000 to UHC, they unbundle it and return a payment for 93005 and 93010. We bill thousands of EKGs per month btw.

They state it is a Medicare policy that they are adjusting their own policy to but I have not found a Medicare policy on this.

Any feedback?
 

TheStephCode

Networker
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The problem that we're having is in the auto payment posting. UHC's policy of unbundling causes us to have to manually edit and post each and every EKG reimbursement which, for hospitals, can be thousands of encounters per month.

Has anyone else encountered this? I would be very interested in grouping up with any entities that are fighting it. Many fingers make a mighty fist, eh?
 

LunaPecura

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I've been having the same issue for several months! I bill for a family practice with three (now down to two) providers, so manually fixing the e-remits is not that big of a deal (yet). I could run some reports and try to find a pattern if you're interested, just shoot me a message with your email address! :)
 

Jbeck@karuk.us

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Unbundling 93005

That seems like a weird way for them to do that as the RVU is the same both ways.
I have had a request from my biller to code 93005 & 93010 instead of 93000, and I thought it was sketchy, but if MCR is unbundling them anyway, is it OK to just code them that way in the 1st place? Do you have any new information on this?

Thanks so much!

J. Beck, CPC
 
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