Wiki Modifier PT with 53

[taylor.mcgovern@gmail.com]

Hello! I am newer to billing for Gastroenterology and I need some help!

Patient was seen for a colon screen- few small mouthed diverticula were found in sigmoid colon also large amount of stool causing DR to abort.

Claim was originally billed as 45380 PT 53. Medicare denied for invalid combination of HCPC modifiers.


Any ideas?

Thanks!!

 

[abby4623]

Medicare will always deny for a 53 modifier. You will have to submit records to show why it was incomplete. We typically always submit our Medicare claims that have a 53 mod w/ records at the same time.