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ABN modifiers 2010

  1. #1
    Question ABN modifiers 2010
    Medical Coding Books
    I got a newsletter last week and just read it today. It states there is a new modifier for voluntary ABNs, GX. This is for services that are never covered.

    "A new modifier (-GX) has been created with the definition "Notice of Liability Issued, Voluntary Under Payer Policy" and is to be used to report when a voluntary ABN was issued for a service. You may use the –GX modifier to provide beneficiaries with voluntary notice of liability regarding services excluded from Medicare coverage by statute, and in these cases, you may report it on the same line as certain other liability-related modifiers. Please note that the –GX modifier must be submitted with non-covered charges only, and your FI or A/B MAC will deny the claim as a beneficiary liability. "

    Do we have to get these now? This is the first I have heard of it and really don't look forward to dealing with more paper if we do have to get ABNs on never covered services.

    Medicare states this "These changes are informational only for Medicare Part B and Durable Medical Equipment Medicare Administrative Contractors and do not impact claims processing for the Multi-Carrier System and the ViPS (Viable Information Processing System) Medicare System."

    Laura, CPC, CEMC
    Last edited by LLovett; 11-24-2009 at 12:55 PM. Reason: added link to cms site

  2. #2
    I too was concerned about this new ABN modifier and all its implications. I read in a Decision Health publication that this modifier was limited to institutional claims, but no one else has published this distinction. I emailed with the "Part B News" editor and he confirmed that he had been in contact with CMS who confirms this in fact, is limited (at this time) to institutional claims.
    Jenny Berkshire, CPC, CEMC, CGIC

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