Wiki modifier GZ

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Shawna Paul

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Can anyone tell me if modifier GZ can be used on ER encounters or does it just apply to clinic visits.

Thanks in advance for any information.

Shawna
 
Hi there, it will depend on the patient's condition. You can't issue ABNs to patients during a medical emergency.

40.3 - Medical Emergency or Otherwise Under Great Duress Situations

(Rev.: 4197; Issued: 01-11-19; Effective: 04-15-19; Implementation: 04-15-19)

A written notice should not be obtained from a beneficiary in a medical emergency or otherwise under great duress (i.e., when circumstances are compelling and coercive) since that individual cannot be expected to make a reasoned informed decision. A beneficiary (or authorized representative) cannot be expected to make an informed, rational decision when in an emergency situation and therefore cannot be considered a capable recipient. If the beneficiary is not capable of receiving the notice, then the beneficiary has not received proper written notice and cannot be held liable where the LOL or RR provisions apply, and the notifier may be held liable
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https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c30.pdf
 
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