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Is anybody having trouble with UHC denying CPT code 90734? They tell me that it is a pharmaceutical vaccine that needs to be billed with Mohealthnet! These kids are not 19 years old. They are no help, just wondering if anybody is having the same issues.
thanks
Yes I am
I have actually had 4 deny. They give me the code 109 which says claim/service not covered by this payer/contractor.
I am having trouble with United Healthcare Community with the same code (109) too. I have had several claims deny.
They always paid until recently when they went to the new billing model. Do you guys bill through Link for UHC? The last 3 claims for immunizations have been denied. 109 denial means they have other insurance. I got denial codes on last claim: Codes 109, 252, M23, N418 and 3(BS). I have never had that many denial codes! I billed it exactly like I always do. We have denial of 90734 and 90649 for commercial insurance because they said it an elective immunization.
Yes I bill through link. Do we know what website for Managed Care UHC we are supposed to go through? Their claim department can’t tell me, I do have an email for a rep from UHC to contact me hopefully she will know something!!
This is what I found this morning as far as provider contacts. https://www.uhcprovider.com/en/health-plans-by-state/missouri-health-plans/mo-comm-plan-home.html?rfid=UHCCP Im going to try and contact someone also and will update if I hear anything. Thanks!
Contact your Provider Advocate. I had a zillion denials but she got me to the right person and it all was problem with our address. Got it all straightened out.
Okay I got in contact with my rep and this is what has happened.
There is a system issue that was identified for VFC vaccines. Per the claims department, VFC claims are denying incorrectly. The system has been updated and the claims department has submitted a project to CPM to capture all claims impacted.
This issue will be tracked under Issue or MID #1204759, I will provide updates as I receive them. This impacted the entire state of Missouri so it may take up to 30 days for the claims project to be completed. Thank you!
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