Wiki TC modifier

[notatthebeach@gmail.com]

Recently, one of our Medi-Cal HMO/IPA payors started denying our 81003's stating that a TC modifier is required for this test. I have appealed it stating that we do this test in house with our own equipment. They still uphold their initial denial stating that, per Medi-Cal guidelines, a TC modifier is required for this test. I searched the Medi-Cal website high and low for this guideline that they are saying exists and other websites, but am unable to locate such guideline. Can anyone else shine some light on this?

Thanks!!

 

[carlystur]

Ask them to tell you where you can find this guideline. Then, keep them on the phone while you go to where they say to go. I would suggest that unless anyone else has any other ideas.

 

[notatthebeach@gmail.com]

That was my next step. Thanks!!