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Wiki Add-on code 01968

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j_ruiz10

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Anyone having issues on getting CPT code 01968 paid by Medicaid MCO's? In our scenario the primary CPT code 01967 is billed with the provider who did the epidural but then many hours later another provider provides their service for the emergency c-section. The MCO (mostly Driscoll) is denying our add-on code stating that the code is being billed without the main procedure code. The primary code is billed 01967/QZ U1 and the emergency c-section is being billed 01968/77 QZ U1. Any suggestions would be greatly appreciated. (Note: We have also tried submitting the add-on code as 01968/QZ U1 77. We were billing this code without the 77 modifier at 1st but then started receiving a bunch of denials).
 
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