Code/Modifier Combination Invalid and Modifier Invalid/Missing - B18,CO4, MA130

Remark Code/ Message Number:

• B18: Payment adjusted because this procedure code and modifier were invalid on the date of service

• 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:

o Jurisdiction 1: Select 'Articles' on the left side of the Palmetto GBA Web page

o Ohio, South Carolina and West Virginia: Select 'Browse by Topic' on the left side of the Palmetto GBA Web page.