Wiki Medicare Patients

[Sylvia Lara]

Medicare patients

Hi, on the Medicare patients we bill a pap Q0091 with the G code. This is for the patients that need a pap screening every two years. We add the modifier
GA to the G code stating the patient has signed an ABN. On the Q0091 code we are being asked for a modifier. I have checked previous information and it states that the modifier 76 is to be used. The 76 modifier-is for repeat procedure by same physician. It doesn't seem like to correct modifier. Does anyone else have another modifier? Or is this the correct modifier? Please Help

 

[carafry]

medicare modifiers

We have always used the -GA on both the G and Q codes when an ABN has been obtained. You should also append a -25 to the preventive or E/M if a visit is also being billed.

 

[MISSI]

You would not use the -76 modifier, but correct in using the GA on both codes with an ABN from the bene.

 

[Sylvia Lara]

Medicare patients

Thanks for the information, we will continue billing the G and Q codes and adding the GA modifier to the Q code.