Here is the correct way to bill Medicare: 993xx-GY, G0101-GA, Q0091-GA
Modifier GY indicates, that this is a non-covered Medicare Service submitted for secondary consideration. Modifier GA indicates that a Medicare ABN has been obtained (provided that all criteria has been met at tos).
Regarding commercials, submit the services according to their guidelines. Blue Shield has always been a class on its own regarding coding. Many comercials consider that the Q0091 is bundled within the 993xx and according to many insurance contracts, inappropriate to bill the patient. It's always recommended to know coding/billing requirements for all carriers.
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