Cardiology Coding Alert

If you started coding a decade ago, you may remember using modifier GX for noncovered services. You'll have a new modifier GX in 2010, but it has an all-new descriptor and all new rules.

What's new: CMS will update two advancebeneficiary modifier (ABN) modifiers effective April 1, according to MLN Matters article MM6563, dated Oct. 29.

The ABN descriptors will read as follows:

• Modifier GA will change from "Waiver of liability statement on file" to "Waiver of liability statement issued as required by payer policy." You'll use this when your practice issued a required ABN.

• All-new modifier GX will be defined as "Notice of liability issued, voluntary under payer policy." You'll append this modifier to claims when you've issued a voluntary ABN.

Currently, you can append modifier GA when you issue the ABN for either required or voluntary reasons, says Zia Clarkson, a coding, reimbursement, and practice management consultant in Long Island, N.Y.

Keep in mind: When you know an item is statutorily non-covered, you don't have to issue an ABN and submit the claim to your carrier with a modifier appended, but you can.

For more on the new ABN modifiers, visit www.cms.hhs.gov/MLNMattersArticles/downloads/MM6563.pdf.