Wiki Modifier 52 on a screening colonoscopy

[lindam@caricures.com]

I am in PA. Billed Medicare G0105 with modifier 52 because he had a poor prep. Cecum was reached so I didn't use 53. Medicare is denying the claim. N519 Invalid combination of HCPCS modifiers. Claim/service lacks information which is needed for adjudication. Is there a rule about this, can someone point me to the information for future reference. Thank you

 

[nickelclaw]

If cecum was reached no mod needed.