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Help with 36478

  1. #1
    Talking Help with 36478
    Medical Coding Books
    I need some help please!! We have been receiving denials for 36478 with denial codes
    CO4 and MA130. All have been billed with the RT or LT modifier. Any suggestions?

  2. #2
    Default
    Have you called the insurance company to find out what those denial codes mean? I would try that first.
    Chastity Nault, CPC
    HIM Professional Services Coder - Remote

  3. #3
    Location
    Salt Lake City
    Posts
    841
    Default
    are you billing the 36478 with another code?
    Jenifer McPolin CPC, CPMA, RCC

  4. #4
    Default
    I sure have. Those denial codes state invalid and/or missing modifier for the CO4. The MA130 states that claim contains incomplete and/or invalid information.

  5. #5
    Default
    Quote Originally Posted by jmcpolin View Post
    are you billing the 36478 with another code?
    YES, we are billing the 36478 WITH 37765

  6. #6
    Default
    There are no CCI conflicts. Does the insurance company not recognize modifiers LT and RT?
    Chastity Nault, CPC
    HIM Professional Services Coder - Remote

  7. #7
    Location
    Salt Lake City
    Posts
    841
    Default
    That is strange I used to work for some vascular surgeons and we did that all the time the only denial I ever saw was for the dx code. Is it just Medicare or all payors?
    Jenifer McPolin CPC, CPMA, RCC

  8. #8
    Default
    That's why I am stumped. We've checked the CCI edits, NCDs. etc. We are billing a varicose vein dx and it's just Medicare that's denying them. We have even tried to take the RT or LT off and it still denies

  9. #9
    Location
    Salt Lake City
    Posts
    841
    Default
    are you using the 454.8? I would call them and say um what are you people doing lol
    Jenifer McPolin CPC, CPMA, RCC

  10. #10
    Default
    I agree. Ask to speak to a supervisor if you have to.
    Chastity Nault, CPC
    HIM Professional Services Coder - Remote

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