# Modifer 24 and 25 for ODJFS



## gepp (Apr 25, 2009)

I work in a Family Practice.  We do charge entry, but a billing company posts the payments and works the claims.  I have been told by this billing company that ODJFS (medicaid) does not recognize modifier 25 and they will only accept modifier 24.  I have searched through the ODJFS Manual and can not locate that reasoning.  Does anyone know anything about this?  Our physicians do not do surgery so I don't understand their reasoning behind this.  I need something in writing if anyone can help.
Thank you,
Gail


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## LOVE2CODE (Apr 25, 2009)

gepp said:


> I work in a Family Practice.  We do charge entry, but a billing company posts the payments and works the claims.  I have been told by this billing company that ODJFS (medicaid) does not recognize modifier 25 and they will only accept modifier 24.  I have searched through the ODJFS Manual and can not locate that reasoning.  Does anyone know anything about this?  Our physicians do not do surgery so I don't understand their reasoning behind this.  I need something in writing if anyone can help.
> Thank you,
> Gail



Yes, this is correct that MOST MEDICAIDS don't accept modifier 25. You could get this info from your provider relations person. It should be stated in your contract w/them.


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## gepp (Apr 26, 2009)

Thank you for your response. 
When you say Most Medicaids, would that also apply to Wellcare and Caresourse?  I am in Ohio and these are some of the other plans in the Medicaid system.
Does anyone know the reason they do not accept 25?  I find it interesting due to the fact that 24 and 25 have different reasoning for their uses.  
I will have to get in touch with the provider relations dept.
Thank you


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