Nancy Posted Thu 08th of December, 2011 17:40:37 PM
Medicare denied claim due to modifier. Medicare does not accept modifier 51. What would be the correct modifier for payment.
billed --- 58953-22
denied due to modifier
SuperCoder Answered Thu 08th of December, 2011 19:43:35 PM
You have billed:
Denial Reason: Denied due to modifier.
Medicare should not deny modifier 51.
It should be:
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.
Nancy Posted Fri 09th of December, 2011 12:31:29 PM
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.