brake
Networker
Can someone give an example of GY and the GZ modifiers. I need some clarification on both.
I work in a practice where services are done to pts who are eligilbe for Medicare for some reason, but the services are not a covered benefit by Medicare. eg: a 33 year female (medicare eligible) needed and x-ray for an injury, but because she child was bearing age so the x-ray falicilty requires a pregnancy test before the x-ray can be provided to the pt. (understandable)
Also I have a provider who likes to perform labs even when we know that Medicare will not consider this "medically necessary" (the dx)
I know we should be utilizing ABN/exclusion waiver forms, but I am the CPC not management and managment refuses to address these issues. Stuck b/w a rock and hard place.
Thanks !
Shaunta Brake,CPC
I work in a practice where services are done to pts who are eligilbe for Medicare for some reason, but the services are not a covered benefit by Medicare. eg: a 33 year female (medicare eligible) needed and x-ray for an injury, but because she child was bearing age so the x-ray falicilty requires a pregnancy test before the x-ray can be provided to the pt. (understandable)
Also I have a provider who likes to perform labs even when we know that Medicare will not consider this "medically necessary" (the dx)
I know we should be utilizing ABN/exclusion waiver forms, but I am the CPC not management and managment refuses to address these issues. Stuck b/w a rock and hard place.
Thanks !
Shaunta Brake,CPC