depaul
Contributor
A Medicaid Pt had left foot surgery on 11/26/2019. On 12/11/2019 Pt returns to office for a visit and discusses surgery on right foot. Billed 99213, -24.
Medicaid paid the 12/11/19 E/M with modifier 24, (and paid the 2nd surgery DOS 12/24/2019). But Medicaid denied the first surgery 11/26/2019. I called Medicaid, the rep said the 1st surgery on the left foot on 11/26/2019 is denied because of the 12/11/2019 office visit because of the 24 modifier. Rep stated the office visit on 12/11/2019 needs the 90 day global modifier. I told her it has modifier 24. She said Medicaid does not follow CPT, they have their own guidelines, nor do they allow modifier 24. She said when I correct the 12/11/19 DOS with a 90 day global modifier then the 11/26/19 surgery will be paid.
Has anyone else come across this? And if not modifier 24, what 90 day global modifier is CO Medicaid wanting?
Thank you!!!
DP, podiatry
Medicaid paid the 12/11/19 E/M with modifier 24, (and paid the 2nd surgery DOS 12/24/2019). But Medicaid denied the first surgery 11/26/2019. I called Medicaid, the rep said the 1st surgery on the left foot on 11/26/2019 is denied because of the 12/11/2019 office visit because of the 24 modifier. Rep stated the office visit on 12/11/2019 needs the 90 day global modifier. I told her it has modifier 24. She said Medicaid does not follow CPT, they have their own guidelines, nor do they allow modifier 24. She said when I correct the 12/11/19 DOS with a 90 day global modifier then the 11/26/19 surgery will be paid.
Has anyone else come across this? And if not modifier 24, what 90 day global modifier is CO Medicaid wanting?
Thank you!!!
DP, podiatry