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.




Last Updated: 02/08/2018