Wiki Medicare WWE

[LargoFLSunshine]

We have had every Medicare claim (2011 dates of service) for a WWE deny since we did the 5010 update for

"CO-4: The procedure code is inconsistent with the modifier used or a required modifier is missing. Note: Refer to the 835 Healthcare Identification Segment (loop 2110 Service Payment Information REF), if present".

We are submitting the claims they way we always have;
G0101-GA
Q0091-GA as weh have an ABN on file.

Is anyone else having this problem? I wanted to try here prior to calling Medicare as normally they cannot help and I have a hard time navigating their website. Am I supposed to be using a new modifier?

Any help would be greatly appreciated!

Marcie S., CPC

 

[LargoFLSunshine]

Okay, Just wanted to update everyone;

Per Medicare, they think they were deneid due to us not adding the modifiers in all caps. This is something I overlooked as it used to be done automatically prior to the last upgrade. If anyone else is having this issue, this may be a simple solution.

Thanks,

Marcie S, CPC