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Printed Date: 9/22/2015
Failure to submit one or more of the following requirements can result in the rejection of services billed with CPT modifier 55.
CMS-1500 (02/12) Paper Claims
Electronic claims — ASC 837 v5010 Loop, Segment, Element
As a reminder, claims that are rejected with remittance message MA130 should be corrected and resubmitted as new claims. Rejected claims do not have appeal rights. Reopening and redeterminatation requests received for rejected claims will be dismissed.
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Last Updated: 03/01/2021
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