VA Optum Health Recoupment of Cupping 97039 Suspended

Good news!!!!

VA Optum Health Recoupment of Cupping 97039

Today we received notice that Optum Health is rescinding the recoupment for the past payments of cupping under the unlisted service code 97039. Many member offices received letters of recoupment that amounted to thousands of dollars.

But as I had noted to the offices that reached out this recoupment was improper as the Standard Episode of Care (SEOC) and allowance of codes for acupuncture from 2021 to February of 2024 did indeed include the unlisted code and was payable.

They did indeed change the code for cupping as of February 2024 to only be coded under 97016 but in prior years 97039 was included and allowed. We formulated a dispute letter many offices sent noting the dates of each of the SEOC that did indeed include the use of 97039.

It worked and here is the response from Optum

Good morning–

Optum’s Claims Department worked a special project intended to remediate a historical claims logic concern which impacted unlisted procedure codes. Although our analysis of the unlisted procedure codes is ongoing, the current recoupments are in the process of being voided. We sincerely apologize for the inconvenience this has caused and appreciate your patience as we work to void theses specific recoupments regarding the unlisted procedure codes. Additional communication will be sent in advance of any further actions related to the unlisted procedure codes after our internal analysis is complete.

Sincerely,

Edgar L Neira

Network Provider Advocate, Network Management | OptumServe

VA CCN Region 1, 2, 3

AAC Network members should you get any added requests please contact me to get the dispute letter for your response.