Wiki Mammogram Screening

[koutler@gmail.com]

I received a denial from Medicaid when using CPT code 77067. They stated that I needed to add a modifier on it. I was under the impression that since the code it self is for a bilateral screening that it doesn't require a modifier. No other carriers are requesting a modifier for this code. Can someone please give me some insight on this?

 

[chembree]

Are you billing globally or for the TC or PC side? Which state are you billing for? Has the PT had a mastectomy?

 

[CodingKing]

What state? Some states Medicaids have different modifier requirements than any other payers. For example Medi-cal may require U7 modifier.

 

[koutler@gmail.com]

I'm in the state of Georgia. No the patient hasn't had a mastectomy. I'm billing from the PC side.

 

[chembree]

Georgia should not require any modifier other than a 26 if billing the PC side.