Question 97110, 97140

cjagustin

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I am seeing an increased trend of denials for 97110 and 97140 for invalid modifiers from Humana Medicare Advantage in our hospital claims. These were billed with modifiers KX and GP. I don't know what I am missing that is causing for these to deny. I am wondering if there has been a change in policy with Medicare. I would appreciate inputs. Thank you.
 

sarab86

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Fort Myers, FL
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We have found that Humana Medicare only wants the GP modifier on the Evaluation PT code only. They will not process the claim if there are extra modifiers that they dont want. We have had to stop reporting the GP modifier on all other PT modalities/line items for them to pay.
 
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