You would use the GY if you know that medicare is not going to pay (eg annual exam) but the patient wants to have it done anyways. The GY modifier indicates that the patient has signed an ABN and wants the service done even though Medicare will not pay.
We recently found out that for a urine pregnacy test you can add a -QW modifier and they will process this. I am not sure what other test you could add this too. I hope this helps some.
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