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Medi-Cal California and LT and RT modifers

M

medicalsec

Guru
Messages
117
I am in California and no matter what I do I can't seem to get the second line of a claim paid when using the LT and RT modifiers for breast bilateral claims when the two codes are different. Medi-Cal has it's own way of doing things!! They keep denying for NCCI edits. Customer service can never explain the denials. I am billing 19307 with a remark entry that shows Line 1 = 99 + AG + RT, and I am billing CPT code 19303-LT on line two of the HCFA form. The TAR has all of the modifers that should match my claim, and I can't really find any examples under the General Surgery claim examples on the website that would indicate a different way of billing. They won't accept two modifers on the same claim line so I am using the 99 entry in the remark section of the claim as I always do on Medi-Cal claims with more than one modifier. Also, I was wondering if they wanted 51-LT on the 19303 line. Has anyone had issues with California Medi-Cal on these types of claims.

Thanks, Dee
 
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