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Thread: Medicare WWE

  1. #1

    Default Medicare WWE

    AAPC: Back to School
    We have had every Medicare claim (2011 dates of service) for a WWE deny since we did the 5010 update for

    "CO-4: The procedure code is inconsistent with the modifier used or a required modifier is missing. Note: Refer to the 835 Healthcare Identification Segment (loop 2110 Service Payment Information REF), if present".

    We are submitting the claims they way we always have;
    Q0091-GA as weh have an ABN on file.

    Is anyone else having this problem? I wanted to try here prior to calling Medicare as normally they cannot help and I have a hard time navigating their website. Am I supposed to be using a new modifier?

    Any help would be greatly appreciated!

    Marcie S., CPC

  2. #2


    Okay, Just wanted to update everyone;

    Per Medicare, they think they were deneid due to us not adding the modifiers in all caps. This is something I overlooked as it used to be done automatically prior to the last upgrade. If anyone else is having this issue, this may be a simple solution.


    Marcie S, CPC

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