Good afternoon,

I wanted to touch base again on the Optum nonbundled claims. I dug deeper into the claims and noticed that some of our claims are billing with 85 value code and no 61 value code. Those claims are all being denied. Some claims are billing with no 85 or 61 value codes and those are paying. We work out of Epic so I brought this to IT to see why it's generating an 85 on some claims and not others. I believe Optum nonbundled should follow Medicaid guidelines. When I look at our MA claims they are not billing with 85 or 61 value codes. What are your thoughts should the nonbundled Optum claims follow MA guidelines? Do you think that the 85 value code should be removed? Thank you all for your input. These Optum claims have me confused and I am getting mixed information from Optum.