One of the Top Denials That Suppliers Receive is Reason Code 4, Remark Code N519, HCPCS Code is Inconsistent with Modifier Used, or Required Modifier is Missing

Tired of rework for correcting claims and rebilling when required modifiers are missing or HCPCS code does not require modifier that was appended to claim line? This is one of the most frequent denials that suppliers receive. We have the solution, utilize the Noridian Modifier Lookup Tool to ensure all potential modifiers are included on the claim along with referring to the appropriate Local Coverage Determination (LCD) and LCD Policy Article for required modifiers. To resolve denial:

  • Correct claim line with appropriate required modifier and resubmit claim
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