University
Physicians
Audit and
Reimbursement Department
Effective 10/1/02
ClaimsManager
The ClaimsManager Knowledge Base has been undated
to the latest Version 8.3 of the CCI which was effective on October 1, 2002.
Effective 6/18/02
ClaimsManager Rule
u36 United Healthcare Office and Prev Med Rule
This rule will edit on the preventative medicine codes (99381 through 99429)
when billed with an Office visit code (99201 through 99215) on the same
date of service by the same provider for a UHC payor.
The edit description will read "United HealthCare will not pay both 993XX
(prev med) and 9921X (office E/M), according to our managed care contract.
It is suggested that one of the services be deleted." It will be necessary
to delete one line and toggle the other to get the edit to drop.
Effective 5/1/02
ClaimsManager Rule
uBL BC/BS Bilateral Code 50 Mod
BC/BS wants a bilateral CPT code listed on 2 lines with the 50 Modifier
on the 2nd line.
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