EY Modifier


Helena, MT
Best answers
I am dealing with Noridian on an issue with eye glasses. Patient ordered glasses with a tint V2744, it was billed with LT, RT and EY modiifiers and 2units. Billed on one line. It denied at Noridian as CO-176. Which I can't bill the patient until I can get Noridian to deny as PR-whatever.....
So I called Noridian and they informed me that I needed to add the GA modifier to the claim...

The LCD states that the EY modifier needs to be present to let CMS know that it was pt preference and that no order was from the physician.
CMS is stating that the EY modifier is "no order from physician" and requires an ABN thus needing the GA modifier.

Has anyone run into this prior? I am relatively new at billing out DMERC supplies, but seems to me that if the language is coming from CMS to add the EY modifier that the claim would process with no problems. It states no mention of adding the GA modifier. I had to call to figure that out.

I just want to bill it correctly and hope that you will have some insight for me.

Thank you

Patti James