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Wiki 63 modifier

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msagely

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Does anyone have any experience with billing a pediatric procedure with a 63 modifier? I am attempting to bill a lumbar puncture (62270) with a 63 modifier but BCBS is rejecting the claim stating "missing or invalid information". Any insight is appreciated.

Thank you,

Michelle Sagely
 
Hi,

Michelle Sagely

I have been working in coding denials since a while & have never encountered such an issue.

i would suggest to check the Pt name and demographics, if you find every this is appropriate then send an appeal to BCBS.

Thanks
Pandiselvi
 
msagely said:
Does anyone have any experience with billing a pediatric procedure with a 63 modifier? I am attempting to bill a lumbar puncture (62270) with a 63 modifier but BCBS is rejecting the claim stating "missing or invalid information". Any insight is appreciated.

Thank you,

Michelle Sagely
Click to expand...

The 63 modifier is for use with infants weighing less than 4kg(8.8lbs), there fore your claim must reflect this information... usually in box 19
 
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