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PA Medicaid 99204 in Wound Care facilty

B

Bombinat

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I received a denial from PA Medicaid on our wound care facility claim, stating that we needed a modifier.

Any ideas?

Alexandra
 
Depending on what state your in...

I code in CA, and for Medi-Cal (our version of medicaid), when services are "incident-to," we use U7 (this HCPCS mod varies from state to state, I guess). Also may I advise looking at modifier SA. Again, I would reference your states Medicaid guidelines, as each is different.

Hope this helps,
 
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