Ob-Gyn Coding Alert

Question: How should new modifier -GY and modifier -GX be used?

Michigan Subscriber

Answer: Modifier -GY (Item or service statutorily excluded or does not meet the definition of any Medicare benefit) replaces -GX (Service not covered by Medicare), so the reasons for using it will be the same. Use the new modifier when you submit a claim to Medicare for a service that you know Medicare does not cover but requires Medicares denial before the patients secondary insurance will pay. This modifier will most often be used with noncovered preventive service codes 99387 and 99397.