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Gastroenterology - I have a claim that Medicare denied procedure

K

kcowdrey

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Spring Hill, FL
I have a claim that Medicare denied procedure 97605 when billed together with 20102 stating invalid modifier billed with 97605. The procedures were billed as 20102-78-GC and 97605-59-78-GC. I verified in NCCI and these modifiers are appropriate. Does Medicare not want the modifier 78 on procedure code 97605? Should I just remove and submit a new claim? This is the first time I have received a denial on these codes being billed together. Any assistance would be greatly appreciated. Thank you. Kim
 
Gastroenterology

I have encountered Medicare not liking the 78 modifier on the wound vac - I'd do a telephone reopening and have them remove the modifier and reprocess the claim.

Hope this helps!

Ardith, CGSC
 
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