Need modifier or inclusive?

catmedfile

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Hi All,

I am billing an inpatient hospital consult along with CT scan reads with the 26 modifier - Medicare and MediCal pay with or without the 25 modifier on the consult, but other company's (HMO's that are supposed to be using MediCal guidelines as these are MediCal patients) are denying the CT scan reads as inclusive. Does the consult need a 25 modifier even tho MC and MediCal are paying without it. Or are the reads inclusive and MC and MediCal are wrong?

Thanks so much,
Catherine
Neurosurgery Billing Department
 
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