We received a denial for Orofacial Myofunctional Therapy from UnitedHealthcare for ‘procedure code is inconsistent with the modifier used’ ‘the service code was not submitted with an appropriate modifier’. We billed CPT codes 97110 and 97112 together which we usually do. I have never used a modifier when submitting these 2 codes together but I realize coding guidelines change all of the time. Just reaching out to see if anyone has used a modifier when billing these codes together and if so what modifier to use. Also, do you report the modifier on the service lines for both codes or just for one or the other? Thank you.
