Wiki UD Modifier

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hbarney1

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Hello,

Does anyone used UD modifier before? And if so can you explain what the modifier means? I have never seen this modifier before and unable to find the reason online. Any help will be appreciated.
 
something to do with medicaid and drug discounts. you may need to check with your states Medicaid.

https://www.340bhealth.org/files/PP_340B_Avoiding_Duplicate_Discounts.pdf

https://www.cms.gov/Medicare/Medica...illing-340B-Modifiers-under-Hospital-OPPS.pdf

18. How are providers to bill the 340B modifiers for drugs administered to dual-eligible beneficiaries? Is the “UD” modifier required for Medicaid?

When Medicare is either the primary or secondary payer, the appropriate 340B modifier is required in accordance with the OPPS 340B payment policy. Because Medicaid billing requirements vary by state, providers should contact the applicable State Medicaid Program for guidance on billing 340B drugs. Normal CMS policy and procedures and trading partner agreement requirements for coordination of benefits (COB) claims will be followed.
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Okay so for example I have a claim that performed an Abodomen CT with IV and oral contrast at the same time. For this claim the IV and oral contrast were performed at the same time together so I am unable to append a modifier XU since performed together. So I was looking into appending mod UD on it, but it is still not making sense. I have been researching all week for a good definition but it still isn't making sense. Is there anyway you can explain it more? Or you can email me at hbarney2017@gmail.com
 
Are you wanting to bill both the IV solution and the oral contrast? and is this denying from the payer? Is this the facility or the physician claim.
 
mitchellde said:
Are you wanting to bill both the IV solution and the oral contrast? and is this denying from the payer? Is this the facility or the physician claim.
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Yes it denied Q9967 (needing the modifier) with Q9963. Yes they want to bill both the IV and oral contrast but it was performed same time. Yes it is denying from the payer and this is an outpatient claim.
 
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