Code/Modifier Combination Invalid and Modifier Invalid/Missing

Remark Code/ Message Number:

• B18: Payment adjusted because this procedure code and modifier were invalid on the date of service
• 4: The procedure code is inconsistent with the modifier used or a required modifier is missing
• MA130: Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Please submit a new claim with the complete/correct information.

Resolution

• Review the CPT/HCPCS code narratives to determine is a modifier is needed
• Verify that the submitted modifier is appropriate to be submitted with the procedure code
• Access complete instructions for correctly submitting all CPT and HCPCS modifiers on the Palmetto GBA Modifier Lookup Web page:
  • Jurisdiction 1B: www.PalmettoGBA.com/J1B
  • Ohio: www.PalmettoGBA.com/boh
  • South Carolina: www.PalmettoGBA.com/bsc
  • West Virginia: www.PalmettoGBA.com/bwv

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