Hi there,
I had a question about denials that we are getting from Buckeye. They are denying all claims for clients with primary mental health dx that are SRS using the H0038 billing code with no modifier. I know that you need the educational modifier when using the H0038 billing code for an SUD dx. However when I contacted Medicaid about this they said not to use any modifier when billing SRS H0038 claims. All other payers including Medicaid are paying the claims without the modifier except for Buckeye. I have spoken to their claims department and they are looking into it but I was wondering if you had any insight that may help.
Thank you,
I had a question about denials that we are getting from Buckeye. They are denying all claims for clients with primary mental health dx that are SRS using the H0038 billing code with no modifier. I know that you need the educational modifier when using the H0038 billing code for an SUD dx. However when I contacted Medicaid about this they said not to use any modifier when billing SRS H0038 claims. All other payers including Medicaid are paying the claims without the modifier except for Buckeye. I have spoken to their claims department and they are looking into it but I was wondering if you had any insight that may help.
Thank you,