Rebecca Pate
Networker
I am billing 11981 and J7307 for insertion of Nexplanon, and insurance is denying stating 11981 needs a modifier. There are no CCI edits, and I have no idea what modifier might be called for. Help please!-
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Wiki 11981 modifier?
- Thread starter Rebecca Pate
- Start date
I am billing 11981 and J7307 for insertion of Nexplanon, and insurance is denying stating 11981 needs a modifier. There are no CCI edits, and I have no idea what modifier might be called for. Help please!KMCFADYEN
Expert
Are these the only 2 codes on your claim?
Rebecca Pate
Networker
Yes, the only 2 codes. I would maybe understand if there was an office visit. The insurance is PeachState.
CodingKing
True Blue
FP modifier is required under GA Medicaid when billing for family panning services. Looking at this document from 2013 (not sure how up to date) Page 32
http://dch.georgia.gov/sites/dch.ge..._of_Public_Health_Billing_Resource_Manual.pdf
http://dch.georgia.gov/sites/dch.ge..._of_Public_Health_Billing_Resource_Manual.pdf
KMCFADYEN
Expert
Some insurance require FP modifier
tmc59
New
Would a laterality modifier be needed Lt or Rt based on which arm it is inserted???
nielynco
True Blue
No as the procedure is the same no matter which arm you use and you would never insert in both arms so no differentiation would be required.