General Category > General Questions

MODIFERS/MEDI-CAL

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suuzq:
What is the appropriate modifer to attach to code 69210 when billing Medi-cal (California)?  My claim was denied by Medi-cal stating procedure requires modifer.  Both 99214 and 69210 were billed on same day.

Thanks!

Michele:
That would be a Medi-Cal specific coding issue.  Sorry but I don't currently bill Medi-Cal (and I'm thankful for that!).

Claudelia:
Since it's technically a 'surgery' code, you might try the AG modifier.  I would also use the 25 modifier on the 99214 if it's warranted.

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