• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

United Healthcare/RFA's

F

Florida1

Contributor
Messages
16
Location
Milton, FL
Has anyone had any success getting the RFA's paid for by United Healthcare? We have a handful of patients that my doctor has done the RFA's on (CPT 64635 & 64636). United Healthcare keeps denying them as experimental.....can anyone help??
 
We are billing according to the UHC coverage guidelines and they are still denying as experimental. I am in the process of looking at our individual contract to see if there are roadblocks there.
 
Has the doctor performed a Medical Branch Block with 50% or more relief prior to the RFA?
If the answer to this question is no, then that will get you a not medically necessary denial from United Healthcare
And has the patient had previous RFA less than six months prior?
If the answer to this question is yes, then that will get you a not medically necessary denial from United Healthcare.
 
You must log in or register to reply here.
Top