Wiki BCBS HCPCS Modifier Denial

[bonedocs2]

We have suddenly received several denials on surgeries - missing HCPCS modifier. We have the anatomical modifier on the claim. In this case 28043-RT. Anyone have any idea what they need?? Anyone else seeing this?

 

[Deborah Marsh]

Hi - Was any other service provided on the same date? Or, since it was sudden, maybe it was a payer glitch. I didn't see anything on the ortho and podiatry forums, but maybe you'll have more luck than I did there.

 

[elwoodgrulke@yahoo.com]

Hopefully already figured this out - looks like BCBS is looking for the HCPCS digit modifier, i.e. T5 - T9 if SX proc is for a digit on RT foot.