Forum - Questions & Answers

Dec 18th, 2014 - MBrashear

Modifiers

During a recent chart audit, I found a procedure had not been billed. The Doctor turned in a charge for a Cesarean section, but failed to turn in the charge for the postpartum tubal. The claim was submitted to Anthem carrier with the appropriate provider adjust form adding the tubal to the original claim.
Anthem has denied the claim stating the tubal needs a modifier. I have never used a modifier on this combination. Has something changed?



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