Wednesday 1 April 2015

Insurance denial - procedure code is inconsistent with the modifier

The procedure code is inconsistent with the modifier used or a required modifier is missing. Denial code 4


1.Modifier may be inconsistence with the procedure code
2. Modifier may be invalid for this procedure.
3. We may filed the claim without modifier.


Action : 
We need to check the modifier which we used it may be invalid or inappropriate. We have update and rebill the claim with correct modifier. 

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