(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)
We use the GY modifier for Medicare billing. One reason is that it is our policy to bill all carriers for all procedures, but since Medicare does not reimburse for certain procedures, then we append the GY modifier. Another reason is that Medicare will deny an entire claim unless they see certain procedures - even though they do not pay for those procedures! As an example - Medicare does not pay for fluoroscopic guidance (77003), but a few pain management injections require fluoro guidance to be paid. If we did not bill the fluoro (even though it will not be paid) then the entire claim would be denied. In this case, we must bill the fluoro (with a GY modifier) in order to get paid.
Richard Mann, your pain management coder
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