WIC diagnosis code

[Missouri Public Health Association]

I am having difficulty getting our WIC assessments and hemoglobins paid from UMR. They don’t like the Z02.9 or Z02.89 diagnosis codes. Has anyone else had this problem? Can you suggest a diagnosis code that will work?
Many thanks, Diane

[Missouri Public Health Association]

We use z130 – and proc code 85018

[Missouri Public Health Association]

You are billing private insurance for WIC?

[Missouri Public Health Association]

When billing MC+ plans, I resubmit with DX codes Z71.89 & Z01.89

[Missouri Public Health Association]

When we have a client that has Medicaid and Commercial as primary, we need to get a denial from the primary so Medicaid will pay. The comment that UMR gives is not a denial but a request for the correct diagnosis code. I’m sure they won’t pay anyway but we have to have a proper denial so Medicaid will pay. Occasionally, the commercial insurance will pay a portion and Medicaid will pay the rest.

[Missouri Public Health Association]

Diane,
Thank you for that information. I have been writing the patients off that have both commercial insurance and Medicaid.

I use Z01.89 for all my hemoglobins- at this point I only bill Medicaid for WIC visits.

[Missouri Public Health Association]

Diane

I use z130 proc code 85018 for hgb and for assessments use z0189 for adults proc code 99211 and z008 for kids with proc code same but use modifier EP. This is only for mediciad plans I have never tried to bill a private insurance.

[Missouri Public Health Association]

I also bill the way Carol does.

[Missouri Public Health Association]

I have had issues with it paying for lead testing. im using Z77.011 and 83655. What am i doing wrong? Thanks!

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