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Thread: Modifier GZ???

  1. #1

    Default Modifier GZ???

    AAPC: Back to School

    I bill for pain management injections in an ASC.

    Does any one know how to correctly bill a GZ modifier??

    Is it necessary to use the GZ modifier when billing the fluoroscopy to Medicare?

    Per CMS: modifier GZ --item or service expected to be denied as not reasonable and necessary

    I know that the flouro will be denied, but it denies as bundled...not as not reasonable & necessary.

    Im confused!

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    You use GZ for those line items that are statutorily non covered. Like the anual exam, or cosmetic services. These are items you do not need to obtain an ABN but you feel more comfortable doing so. IF you append the GZ to a line item that is not statutorily non covered, your claim will be returned.

    Debra A. Mitchell, MSPH, CPC-H

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