aharoldsen
New
Can you use a 33 modifier and and a GZ modifier?
For our Medicare Provider (Noridian), the following is required for a screening to be covered.
1- A woman who has been determined by a physician or qualified Non-Physician Practitioner (NPP) treating her to be estrogen-deficient and at clinical risk for osteoporosis based on her medical history and other findings.
2-An individual with vertebral abnormalities as demonstrated by an x-ray to be indicative of osteoporosis, osteopenia, or vertebral fracture.
3-An individual receiving (or expecting to receive) glucocorticoid (steroid) therapy equivalent to an average of 5.0 mg of prednisone, or greater, per day, for more than three months.
4-An individual with primary hyperparathyroidism.
BUT there isn't really the same requirements for the 33
The US Preventive Services Task Force recommends that women aged 65 and older be screened routinely for osteoporosis or routine screening begin at age 60 for women at increased risk for osteoporotic fractures.
So would you bill a GZ modifier if you you don't meet the Noridian requirements, AND a 33 because you do meet the UPSTF requirement?
For our Medicare Provider (Noridian), the following is required for a screening to be covered.
1- A woman who has been determined by a physician or qualified Non-Physician Practitioner (NPP) treating her to be estrogen-deficient and at clinical risk for osteoporosis based on her medical history and other findings.
2-An individual with vertebral abnormalities as demonstrated by an x-ray to be indicative of osteoporosis, osteopenia, or vertebral fracture.
3-An individual receiving (or expecting to receive) glucocorticoid (steroid) therapy equivalent to an average of 5.0 mg of prednisone, or greater, per day, for more than three months.
4-An individual with primary hyperparathyroidism.
BUT there isn't really the same requirements for the 33
The US Preventive Services Task Force recommends that women aged 65 and older be screened routinely for osteoporosis or routine screening begin at age 60 for women at increased risk for osteoporotic fractures.
So would you bill a GZ modifier if you you don't meet the Noridian requirements, AND a 33 because you do meet the UPSTF requirement?
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