# Medicare denial CO4



## mackeyjean (Mar 20, 2013)

Hello,

Noridian Admin Serv is my Medicare carrier. 

Since 02/19/13, all procedures billed to Noridian for our Physician Assistant's have been denied with CO4.  (The procedure code is inconsistent with the modifier used or a required modifier is missing.)  An example would be 99213-25 with 17004 and dx code 702.0.  The office charge is processed.  17004 is immediately denied for a missing modifier.  As you are aware, there is no missing modifier.  

Upon receiving the first denial I contact Noridian for explanation.  They swear a fix is in place, however I am now up to 192 procedures denied. 

Is anyone else having the same problem?  Am I missing something that changed?


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## mackeyjean (Mar 20, 2013)

I should also mention the rendering NPI is billed as the PA.


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## peachygirl (May 3, 2013)

*Re: Medicare CO4 issue*

Hello!
We had the same issue, there was an error on Medicare's part in February 2013 having to do with PA claims and requiring modifiers on all procedures--nothing has changed coding-wise it was just a Medicare processing mistake. I have been told this was caught on 03.14.13 and auto-adjustments to all affected claims will begin 04.14.13, however, we have yet to see those adjustments come through.

Hope this helps,

Mallory, CPC, CPCD


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