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eClaims - Common Rejections - Missing/Invalid Modifier

Missing/Invalid Modifier
Rejection Message:

  • Emdeon Reject Modifier code XX is not allowed with procedure code XX (Bad Data: XX )

This rejection states that the modifier that was used in conjunction with a specified procedure code is not allowed. This is likely due to a payer edit that was put in place with the clearinghouse. The modifier will need to be reviewed to be sure that it can be billed with the selected procedure code. Consult with the payer specific billing guide, or contact the payer directly to find out how to bill the selected procedure.

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