eharloff
Networker
Can someone try to steer me in the right direction?
I am in Michigan and I'm running out of patience with this claim denial.
Pt has Blue Care Network, he came in for his Medicare physical, I coded as below:
G0439
96127-59 (they don't use G0444)
G8510
3288F
First, I didn't append the 59 modifier on 96127, then it came back denied, saying it was incidental to the primary code. I then sent it back again with modifier 59 appended, and again came back with incidental to primary procedure code, so my question is, does G0439 need a modifier? Am I missing something? G0439 isn't an E/M code so 25 modifier wouldn't be appropriate. I'm just lost at this point, I have no idea what else to do besides modifiers. He is eligible for a depression screen as it's been 12 months.
I am in Michigan and I'm running out of patience with this claim denial.
Pt has Blue Care Network, he came in for his Medicare physical, I coded as below:
G0439
96127-59 (they don't use G0444)
G8510
3288F
First, I didn't append the 59 modifier on 96127, then it came back denied, saying it was incidental to the primary code. I then sent it back again with modifier 59 appended, and again came back with incidental to primary procedure code, so my question is, does G0439 need a modifier? Am I missing something? G0439 isn't an E/M code so 25 modifier wouldn't be appropriate. I'm just lost at this point, I have no idea what else to do besides modifiers. He is eligible for a depression screen as it's been 12 months.