Modifier Tool Now Available to Avoid Denials

Noridian has developed a website tool that helps suppliers determine which modifiers are applicable for the HCPCS billed. This assists in avoiding claim denials and/or rejections while also offering insight into applicable pricing or informational modifiers. Suppliers who receive the following Reason and Remark Codes on their remittance advices will benefit by using this tool and sharing it within their office.

  • Reason Code 4, Remark code N519 - HCPCS code is inconsistent with modifier used or required modifier is missing
  • Reason Code 50, Remark Code N115 - Item billed may require a specific diagnosis or modifier code based on related Local Coverage Determination (LCD)

An example of the tool depicts the HCPCS entered, the applicable modifiers to consider based on the circumstance, and resources for further research.

The Modifier Look-up Tool can be accessed from either the Education and Outreach / Tools section or from the Browse by Topic / Modifiers / Educational Resources section of our website.

Last Updated Nov 22, 2019