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code 17110

  1. Default code 17110
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    Hello, i'm trying to bill Medicaid for 99214-25, 078.19,17110 and it got denied do i need a modifier what i'm doing wrong? i tryied modifiers 57 or 59 and still got denied. Please help. Thanks

  2. #2
    Location
    Duluth, Minnesota
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    1,133
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    hmm...really? A level 4 visit with a wart removal? What's the denial reason? Does documentation really support the services?
    Donna, CPC, CPC-H

  3. #3
    Location
    Greeley, Colorado
    Posts
    2,045
    Exclamation
    If I remember Medicaid correctly, they don't like modifiers at all...

  4. Default
    When in doubt, you can always call the payor if the denial reason code does not make sense to you. You would, of course, only use modifier -57 on the E/M if it was a decision for major procedure, not minor procedure such as this one. A level 4 does sound high but without the note posted.......

  5. #5
    Default
    99214 does sound high for 078.19, along with 17110. Are there additional diagnosis stated but not coded/billed??

  6. #6
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    our Medicaid provider will not pay for any e/m with a procedure on the same DOS.

    Good Luck

  7. #7
    Default
    Appedn modifier AG. With CPT 17110 or any surgery dealing with medicaid.

    Bill as such.

    99214 no modifer 25 needed. But you can use it. Doesnt matter with medicaid
    17110-AG

    Daniel
    CPC

  8. #8
    Default
    In Pennsylvania, Medicaid only pays for one service per day.

  9. #9
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
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    Daniel,

    Can you explain why you would use the AG modifier for this scenario?

  10. #10
    Default
    mbort
    True Blue


    The AG modifier applies to surgical procedures, or even simple ones like Cryosurgeries. It was brought to my attention by one of my co-workers here at work. He's a collector, very familer with the guidelines dealing with medi-caid. I'm out of California (southern). Don't know if that matters.

    Respectfull
    Daniel
    CPC

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