A modifier is a two-position alpha or numeric code that is added to the end of a Current Procedural Terminology (CPT) or Health Care Procedure Coding System (HCPCS) code to clarify the service(s) being billed. Modifiers provide a means by which a service is altered without changing the procedure code. They add more information, such as the anatomical site, to the code. The Multi-Carrier System (MCS), Medicare's claim processing system, denies claims as "unprocessable" for inappropriate modifier use. "Unprocessable" means the claim is missing certain information or the information present is incorrect. Unprocessable claim denials to not have appeal rights, you must correct the claim and resubmit it for a proper initial determination. Your Remittance Advice (RA) identifies unprocessable claims by the Medicare Outpatient Adjudication (MOA) code MA130 in the upper right corner of the claim information. Code MA130 means, "Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Submit a new claim with the complete/correct information." Please note that because no initial determination is made on a claim returned as "unprocessable," the submitter may not ask for a review or appeal. If the use of a procedure code/modifier combination is inappropriate, you will need to make the necessary corrections and resubmit the claim. Please refer to the current versions of CPT and HCPCS coding books for correct reporting of modifiers.
Tags:
denial reason
ReplyDeleteThe article provided by you is very nice and it is very helpful to know the more information.keep update with your blogs .I found a article related to you..once you can check it out.
No.1 Medical coding training in Hyderabad
Medical billing outsourcing is mostly done from USA where there are many such companies for providing medical billing services efficiently for big health care entities to facilitate their internal processes. It simplifies and resolves issues like medical reimbursement.
ReplyDeleteMedical Coding CPC Training
awesome post presented by you..your writing style is fabulous and keep update with your blogs.
ReplyDeleteCPC Certification Training
nice information..thanks for providing valuable information.
ReplyDeleteEmergency Department training in Hyderabad
thank you for sharing the information. It was helpful.
ReplyDeleteMedical Coding Training
Great Article. its is very very helpful for all of us and I never get bored while reading your article because, they are becomes a more and more interesting from the starting lines until the end.
ReplyDeleteMedical Coding Online Training Hyderabad