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Oncology & Hematology Coding Alert

Modifiers:

Modifier GZ Will Yield Instant Denial Starting July 1

Published on Mon May 09, 2011

Use this table to clear your ABN modifier confusion.Most of the time, when Medicare payers process denials in a speedy fashion, that's bad news for your practice. But when you use modifier GZ, you're already expecting a denial, so it helps you take the claim off of your practice's to-do list. CMS will make these denials happen faster with a new policy to immediately deny all services with modifier GZ appended.How modifier GZ works: If you're still wondering why anyone would want a quick denial, here's a closer look at how modifier GZ works.If the physician performed a service you expect Medicare to find medically unnecessary based on the agency's rules, and there's no Advance Beneficiary Notice (ABN) on file, you should append modifier GZ (Item or service expected to be denied as not reasonable and necessary) to the CPT® code for the service. The advantage of reporting modifier GZ [...]
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