Wiki -GY Modifier

[Yoli]

Hi List,
My question is....On non-covered items such as L3040, do I have to append the –GY modifier in order to bill the patient or can I bill the patient regardless of whether or not the modifier has been appended? I know since this is a statutorily excluded item I would not need to have the patient sign an ABN - but could give a voluntary one for informational purposes to the patient. TIA
Yoli
Reno Orthopaedic Clinic
Reno, NV

 

[OCD_coder]

Always add the modifier as patient's often need a "denial" in EOB format to send in to a 2ndary carrier. Also, eventhough an ABN is "voluntary" for statutorily excluded items, do it, as it saves grief when a patient comes back and says "nobody told me MCR doesn't pay for this." It's just good business and CYA so to speak.