UHC Denials on 97010 and 97014

ChiroCode Hot Topics, October 2007

Denials on these two codes is now the standard routine at United Health Care (UHC). In their Explanation of Benefits (EOB) the denial code for both is “14.” The footnote for 14 is: “This is not a separately reimbursable service or supply. As a reminder; supply codes should be submitted with HCPC codes.” Unfortunately, this is a misleading statement.

Recommendations for UHC Billing

  1. Replace the 97014 with G0283 (like unto Medicare protocol). UHC failed to explain what was needed.
  2. Continue to bill 97010, and expect denials until UHC corrects and updates this old and bad CCI edit.
  3. Inform them that the proper acronym for the Healthcare Common Procedure Coding System is HCPCS, and not HCPC.
  4. Physicians' Current Procedural Terminology (CPT) is a registered trademark of the American Medical Association

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