3221ac11_nual___Child_and_Teen_Checkups__ting_and_Medical_Documentation
[Exception Reason] Unsuccessful attempt (Child uncooperative) [Situation]  Rescheduling for a later date is not feasible  A valid attempt was made to complete the service
 Provider specific documentation of the unsuccessful attempt  Report the correct CPT code for the screening component on the claim  Add the modifier 52 to the claim  Enter your usual and customary charge
MHCP Provider Manual - Child and Teen Checkups
Claim Reporting and Medical Documentation