gaynor64
Contributor
I need help computing the Medicaid of California fee schedule for in office procedures. If anyone could offer assistance it would be greatly appreciated.
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Wiki California Medicaid
- Thread starter gaynor64
- Start date
Hopefully I can help you. If you would like to contact me directly at cjohnson@schsa.org.
bizmatics
Guest
Receiving major denials from CA of Medicaid for modifier on surgery claims
Hi, please help: My practice is brain and spine center and we are receiving major denials on surgery CPT code from Medicaid of California and Partnership Health Plan of California which is Medicaid plan for modifier. Let me also provide you example:
exact denial reason: procedure code is inconsistent with the modifier used or a required modifier is missing,
Example1:
CPT codes billed were: 22842, 22327, 22328, 22610, 22614, 20930, 20936
Example 2:
CPT codes billed were: 63045 and 63048
Once we have also started to submit the claims with UB modifier, cpts were paid but underpaid.
Kindly suggest.
Hi, please help: My practice is brain and spine center and we are receiving major denials on surgery CPT code from Medicaid of California and Partnership Health Plan of California which is Medicaid plan for modifier. Let me also provide you example:
exact denial reason: procedure code is inconsistent with the modifier used or a required modifier is missing,
Example1:
CPT codes billed were: 22842, 22327, 22328, 22610, 22614, 20930, 20936
Example 2:
CPT codes billed were: 63045 and 63048
Once we have also started to submit the claims with UB modifier, cpts were paid but underpaid.
Kindly suggest.
daedolos
Expert
https://files.medi-cal.ca.gov/pubsd...00o02o03o04o05o07o09o11a02a04a05a06a08v00.doc
Peace
@_*
I've dabbled in a few Medi-Cal claims but none with more than 2 cpt codes on a single claim. I've had to use modifier AG for cpt procedures on claims to get them to process with both Medicare and Medi-Cal. And AG is allowed only one use per claim form.
Peace
@_*
I've dabbled in a few Medi-Cal claims but none with more than 2 cpt codes on a single claim. I've had to use modifier AG for cpt procedures on claims to get them to process with both Medicare and Medi-Cal. And AG is allowed only one use per claim form.