tci Part B Insider - 2004 Issue 7

Physician Notes: Denials Due to Invalid Modifiers Are Number One With a Bullet

Carrier lists top-seven denial reasons for first quarter 2004Part B carrier Blue Cross/Blue Shield of Montana released its "hit list" of the top-seven reasons why it denied claims in the first quarter of 2004. As with some previous lists, it put "procedure code and modifier not valid combination" as the number-one reason for denials, accounting for 5,775 denied claims.Also at the top of the charts were denials for provider numbers billed incorrectly or in the wrong combination, an invalid number of services for the procedure code, an unlisted drug code with the drug's brand name written in...

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