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98943

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dfranklin:
Should modifier 51 be used with 98943?  My provider who is a chiro has been billing like that.  But we receive from UPMC a not covered code telling us to resubmit with contracted CPT4, HCPC, Modifier, revenue or other code.  What does this mean? 

Thanks!

Pay_My_Claims:
Billing for the CMT (98940-42) will be the same rules as before the project (that is, the CMT codes must have the -AT modifier (active therapy), or it will be rejected as "maintenance care")

dfranklin:
You said 98940-989420 but does this apply to 98943 as well?

Michele:
Sounds to me like the rejection is saying that 98943 is not one of their contracted codes, which indicates that they don't allow that code.  I find most carriers deny the 98943.  Have you tried calling customer service to verify? 

Michele

Pay_My_Claims:

--- Quote from: dfranklin on February 15, 2010, 03:21:36 PM ---Should modifier 51 be used with 98943?  My provider who is a chiro has been billing like that.  But we receive from UPMC a not covered code telling us to resubmit with contracted CPT4, HCPC, Modifier, revenue or other code.  What does this mean? 

Thanks!

--- End quote ---

I'm no Chiro biller, but from the Chiro forum I am in (smile) It states to NOT use mod 51 with 98943 or you will not get paid!!

http://www.chiro.org/Medicare/Chiroprtactors_Guide.shtml

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