• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Modifier Guidance for Claim Processing

Create Wiki Sort by votes
A

aqibbashir@carecloud.com

New
Messages
7
Best answers
0
I am currently managing billing for a facility and have encountered an issue with claims processing for a patient service date. On the same date of service, we billed three procedure codes under two different providers, both of whom specialize in mental health.

BCBS of South Carolina processed and paid one claim for CPT 99214, but the other claim was partially paid and denied as follows:

  • CPT 90837: Paid $3, with the remainder denied due to inclusive.
  • CPT 96127: The entire amount was denied due to inclusive.
Could anyone kindly advise if any specific modifiers should be applied to these codes to ensure proper reimbursement and processing?
 
You must log in or register to reply here.
Top