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I am getting denials from United Health because I am not using a QW modifier with CPT code 85018. (for WIC claims). In the past they paid and now they are not. Is anybody not there getting these denials?
I was just told by our UHC Rep. that we should use it. Do you also use the CLIA number? If so, where do you list it?
Yes I put the CLIA number in the UHC claims. It is under the General Claim Info section I put the number in the prior authorization box.
Now United Health is denying all of my 85018 with a QW modifier and I am putting the CLIA number in as well. I spoke with my rep from UHC and they are going to do a case project on it. I am not going to bill anymore 85018 with UHC until they get this settled!!
I do not have any problems with the other Managed Care companies.Are any of you getting paid for CLIA services? If so, are you doing anything different than what I’m doing? I have been instructed to put our CLIA number in box 23 and use the QW modifier in order to get CLIA services paid. But we are still getting denied. I have had a case study done, and UHC says “incorrect qualifier G1 submitted in Loop 2300”. I can’t find where to change my qualifier. Whatever it is, I have no idea what it is or how to change it. I am waiting for my provider relations advocate (Leslie Kenedy) to get back from vacation. In the meantime, I am not billing CLIA services.
Also, when I bill for CLIA services, I have been instructed to add our provider to box 17. This is our physician who signs our standing orders.
I have never used the QW modifier with my 85018. I make sure I have the CLIA number entered. We are still getting paid. How recent has this change taken place. Takes for your help.
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