Wiki PA Medicaid 99204 in Wound Care facilty

[Bombinat]

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

Any ideas?

Alexandra

 

[jvilla]

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,