OB Modifiers

I do the billing for a very small OB clinic in Kentucky. I have only about a year's experience in coding/billing, mostly self-taught. I have been billing medicaid for office visits (99204 or 99214), Pap collection fee (Q0091) and breast/pelvic exam (G0101) for quite some time using modifier 25 on the office visit and 33 on the pap collection fee. I have had no problems with this with any MCO's until I recently got a denial from Humana Caresource stating that the modifier was wrong, the only one they didn't pay for was the pap collection. Is there another modifier I should be using? It works this way for all the other MCO's. I can't seem to find another modifier that works with this scenario, unless I just don't put modifiers on them at all, which is what I learned with the G0101. Any help in this area would be greatly appreciated! Thanks so much!

re: OB Modifiers

We use the GA modifier and have the patient sign an ABN for the G0101 and Q0091 since Medicare only covers it once every two years (unless patient meets definition of high risk). If no ABN has been signed, we do not append any modifier to the codes.

re: OB Modifiers

Thank you, I think I will try resubmitting without a modifier. I'll see how that works, but do I still apply the 25 modifier on the office visit?