We're working to resolve some claims denying incorrectly for no anatomical modifier (denial code U54)

We recently experienced a brief issue with CPT, HCPCS and DME codes* that start with a letter (e.g., G0438, H0020, E0955), and which don’t require an anatomical modifier, denying for no anatomical modifier when they shouldn’t.

The issue impacts claims processed between Sept. 24-27, 2024.

There’s nothing you need to do. We’re currently working to reprocess these claims.

We value your partnership and the care you provide our members, and we sincerely apologize for any inconvenience this has caused. Thank you for your patience and understanding.

 

*Note: Some codes do require anatomical modifiers and will continue to deny correctly with explanation code u54.