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Wiki Help with 36478

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bedforak1

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Nashville, TN
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I need some help please!! We have been receiving denials for 36478 with denial codes
CO4 and MA130. All have been billed with the RT or LT modifier. Any suggestions?
 
I sure have. Those denial codes state invalid and/or missing modifier for the CO4. The MA130 states that claim contains incomplete and/or invalid information.
 
That is strange I used to work for some vascular surgeons and we did that all the time the only denial I ever saw was for the dx code. Is it just Medicare or all payors?
 
That's why I am stumped. We've checked the CCI edits, NCDs. etc. We are billing a varicose vein dx and it's just Medicare that's denying them. We have even tried to take the RT or LT off and it still denies
 
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