Wiki Payment included w/another procedure

[tinalashae]

I just started appealing Radiology today and I am lost. I have a claim that denied due to payment included in allowance for another service. The scenario is a doctor billed for CPT 71010 with mod 26 and 76 on d.o.s. 07/10/14 but the doctor also billed for the same CPT 71010 using the same modifiers and this claim paid. Why isn't my other claim paying? The is also Mississippi Medicaid Insurance.

HELP

 

[polycoder]

Medicaid thinks it is a dupe. Add a 59 mod and resubmit.

 

[stephanie7480]

were these for the same DOS? If not there is no global and it is not (or should not be) denying for duplicate. What is the actual denial reason from the payer?

 

[mitchellde]

Why did they submit two different claims? If they were on the same day then the 76 modifier is appropriate on the second one and they should be on the same claim.