Wiki Medical modifier

[bench]

Hi Fellows,

I am coding for an ASC. I just need your input about Medical claims. Primary insurance is Blue Cross and got paid with this procedure, 19120-LT. Secondary insurance is Medical and rejected this claim due to invalid modifier. I called Medical and told me the same saying that LT is not a valid modifier and ask me to go to their website for a valid one. I went to Medical website and I saw that LT is a valid modifier. Do you think LT is an invalid modifier or do I have to add a modifier. A friend told me to code 19120-TC-LT. I'm not quite sure about this. What modifier can i use so this claim can get paid?


Thanks for your help.

 

[bethh05]

Have you appealed this? TC is not a valid modifier for this procedure.

 

[smcbroom]

if you do appeal it, maybe send them a copy of their own website stating that LT is a valid modifier. TC would not be appropriate since it is for the technical component for fluoro, etc. Hope this helps!

Susan