# Medi-Cal AG modifier use



## coachlang3 (Nov 18, 2015)

Has anyone had compliance issues with Medi-Cal's use of the AG modifier for a primary procedure?

They say they use if differently from the national definition.  They use it to denote a primary procedure instead of the correct usage as the primary physician in a shortage area.

According to their website modifier page they want AG on the primary procedure and 51 on all others.

I can't find the actual update from Medi-cal when this went into effect in 2005.

Thanks!!!!!


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## Samantha.Prince (Nov 18, 2015)

*Medi-Cal*

The code sets and modifier descriptions are a nationally set. I would request documentation from the insurer about why this change was made and I would appeal any denials you have received. 

I work for a state Medicaid agency (not Medi-Cal) and we follow the national code sets. Medi-Cal can designate one of their state defined modifiers for that use but the primary procedure should not have any modifiers per correct coding  rules.


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