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Cook Children’s (Texas medicaid) 87804 issues

Good Afternoon All,

My office is having a struggle with Getting cooks to pay both Test A and B. I call and they advise they can’t tell us how to bill it because they don’t guarantee payment. Has anyone had this issue with this specific Payer? What was your solution? This is how we bill 87804(QW)(paid), 87804 59,QW. We receive denials stating inconsistent modifier on the 87804(59):(:confused:

Medical Billing and Coding Forum