Wiki Billing BCG and Interferon

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jcrahan13

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Masshealth is denying the instillation of BCG and Interferon together, is there a modifier that can go on one of these drug codes to get them paid? has anyone else encountered this? Masshealth in the past has covered both of these drugs together. Please help!
 
Drugs do not 'bundle' like professional procedures, so the denial can't be because they were billed together, so I really doubt that this is something a modifier is going to fix - there must be some other issue that is causing the denial. What was the denial reason code? You may have no choice but to speak to the payer about this if it's not clear why one of the drugs was not allowed.
 
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