Medicare Denials
Medicare seems to be denying 93000 (EKG) more than usual. Should I be using a modifier? The denial code is 16: Claim service lacks information, which is needed for adjudication.
Question: Medicare seems to be denying 93000 (EKG) more than usual. Should I be using a modifier? The denial code is 16: Claim service lacks information, which is needed for adjudication.
Answer: Given the denial code, I don’t think coding is at issue. But apparently, there is some information that is missing on the claim. Look for a remark code on the far left side of the paper remittance. This will advise you about what is missing or incomplete.
Newsletter
Optimize your practice with the Physicians Practice newsletter, offering management pearls, leadership tips, and business strategies tailored for practice administrators and physicians of any specialty.
