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PROCEDURE CODE MODIFIER IS MISSING OR INVALID

Rejection Message

PROCEDURE CODE MODIFIER IS MISSING OR INVALID

Rejection Details

This rejection indicates (per the payer) one of the procedure (CPT/HCPCS) modifiers submitted on the claim was invalid for the date of service being billed.

Resolution

Follow the instructions below to edit the modifiers included on an encounter:

  1. Click Encounters > Track Claim Status. The Find Claim window opens.
  2. Look for and double-click on the encounter that needs correcting. The Edit Claim window opens.
  3. Double-click on the Encounter number. The Edit Encounter window opens.
  4. Click into the MOD cell and replace the modifier, as needed.
    • To delete a modifier, select the modifier and click Delete on your keyboard.
  5. Click Save & Rebill

Then, resubmit all affected claims.

 

 

Encounter_Mod1.png

Tip: Most subscription levels include access to a free code scrubbing tool on the Encounter. Utilizing this feature for all encounters can help prevent code rejections.

Note: Kareo Support cannot provide coding assistance. Please contact your biller/coder with any CPT or ICD code questions.