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.

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.