Code/Modifier Combination Invalid and Modifier Invalid/Missing

Remark Code/ Message Number:
  • 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 if 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. Select 'Self Service Tools' on the Palmetto GBA Web page.