TracyBartholomew
Guest
Working in a chiropractic office...
On an initial patient exam we have been billing the office visit, 99201 with the -25 modifier, and it has been rejected over and over by Medicare.
We have since began billing the 99201 with GYGZ in the modifier box.
" Modifier GY should be used when physicians, practitioners, or suppliers want to indicate that the item or service is statutorily non-covered, or is not a Medicare benefit.
Modifier GZ should be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny an item or service as not reasonable and necessary and they have not had an Advance Beneficiary Notice (ABN) signed by the beneficiary."
I have also read that if GY and GZ are used on the same line of service, it will be denied.
Help???
Thanks!
Tracy T., Waterloo, Iowa
On an initial patient exam we have been billing the office visit, 99201 with the -25 modifier, and it has been rejected over and over by Medicare.
We have since began billing the 99201 with GYGZ in the modifier box.
" Modifier GY should be used when physicians, practitioners, or suppliers want to indicate that the item or service is statutorily non-covered, or is not a Medicare benefit.
Modifier GZ should be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny an item or service as not reasonable and necessary and they have not had an Advance Beneficiary Notice (ABN) signed by the beneficiary."
I have also read that if GY and GZ are used on the same line of service, it will be denied.
Help???
Thanks!
Tracy T., Waterloo, Iowa