Medicare DME Same/Similar HELP

[lorig1369@gmail.com]

To all DME billers,
I have a podiatry account I am billing for that is using the GY modifier on DME they know will deny as Same/Similar. They are doing this to get the denial to send to the secondary for payment. The patient has received either the same item or one on the Same/Similar list within 2 years. Is this the correct practice? Should we be billing with the GY modifier knowing that Medicare does indeed cover the item provided it has been the 5 year time frame? I would appreciate any input into this. Thank you

 

[belindapearl]

GY modifier means that the item is statutorily excluded, which to my understanding is never covered by Medicare. I would get an ABN and bill with the GA modifier