Fragen
0
UA Modifiers for 90899 and 90791 MA
Hello
Can anyone tell me why MA keeps denying all our 90899 and 90791 claims? Most of the denials are coming back with a 4. When I call DHS no one can give me definite answers.
Thank you!
Customer support service by UserEcho
Hi Laura,
Are you billing CTSS?
Sheryl
Yes, so then Procentive adds the UA. Is this wrong?
Hi Laura,
Can you clarify what you mean by "UA Modifiers"? We are getting paid for our 90791 by MA. Are you adding modifiers?
Yes the UA modifier gets added to all billed CTSS codes.
I don't believe the 90899 is a CTSS code. It is generally only processed by MA and PMAP's, but we use the U8, U9, UB, UC, U4 U8, U4 U9, U4 UB and U4 UC modifiers only on those. I don't believe 90791 can bill with the UA modifier as it is not a CTSS service - it just recommends CTSS - but I could be wrong.
Does anyone have a code similar to this to use for adult clients?
Its my understanding that 90899 ( UC, UB, U9 & U8) are only for clients 21 and under.
As far as I know, this is only a code for 21 and under. However, we have gotten it paid for disabled adults in the past, with persistence.
Sheryl
If you check the Mental Health Codes and Maximum Adjusted FFS Rate by Date of Rate Change on the DHS website, the only code I can find for adults is for a Psychiatrist. The 90899's show up as Child Outpatient. Sorry!