Mirena IUD - modifier is missing

[astough]

I just received a rejection for a Mirena IUD stating that the required modifier is missing. I did not put a modifier on J7302 and never have. Does anyone know if I need one and if so, what it is?

 

[Leandra]

I have never billed the Mirena with a modifier. Did you put the NDC on the claim? I know payers will deny them if the NDC is missing.

 

[astough]

Yes, the NDC is on. I got another rejection, speaking of the NDC, that said I have to bill the insertion and the device on separate claims if I put the NDC on???? This was new to me too, have you heard anything about that at all? I should maybe mention that these are Medicaid claims.

 

[jesusislord]

I have a question can HCPC code T1015 be used together with an office visit code 9921

I have a question that need clarification. Can HCPCS code T1015 be used together with an office visit code 99211? Please somebody help. My guess is no but I need clarification.

 

[kvangoor]

No, the only thing that can be billed seperatly from T1015 are labs, pharmacy and radiology.

 

[nrichard]

I get this denial a lot with my Florida Medicaid Claims.

Usually one of our AR people just calls and has the claim reprocessed. For my local Medicaid they don't pay for Mirena, they pay for a generic one (I'm sorry the name escapes me). They do pay the insertion though. We are in the process of ordering the one they pay for, and I've yet to bill it out, so I don't know the code for it. As far as the insertion and the device on separate claims , I've not heard of that, but I don't know what state you're in. I'm thinking (and this is just my thought) that maybe they want two separate claims, the one for insertion to go electronic, and the one for the device on paper with the invoice.

 

[mdgask]

If it is medicaid, is it Family planning medicaid. We have to put the FP modifier on our family planning medicaid patients that get the Mirena.