1. Nancy Brewington
   Posted 5 months ago #
   

   Medicare denied claim due to modifier. Medicare does not accept modifier 51. What would be the correct modifier for payment.

   58953
   47381
   39560

   billed --- 58953-22
   47381-59
   39560-59
   denied due to modifier

   thanks

2. SuperCoder
   Posted 5 months ago #
   

   You have billed:
   58953-22
   47381-59
   39560-59
   Denial Reason: Denied due to modifier.
   *
   *
   Answer:
   Medicare should not deny modifier 51.
   It should be:
   58953-22
   47381-51
   39560-51
   Even this may also be denied due to modifier.
   The key reason is not 51, but modifier 22.
   Rule: When you are filing a claim with a CPT with modifier 22, you have to submit the claim with medical records with justifying documentation for modifier 22.

3. Nancy Brewington
   Posted 5 months ago #
   

   Yes documentation for the modifier 22 was submitted with the claim. Medicare does not recognize modifier 51, but we will submit to see if they will pay.

   Thank you

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