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Abn

  1. Default Abn
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    Can anyone please assist my in the ABN arena? Our office bills routinely for the refraction and we append a GY modifier but we never have our patients sign an ABN. Is this required?

    Thank you,

  2. #2
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    Quote Originally Posted by staticsis2 View Post
    Can anyone please assist my in the ABN arena? Our office bills routinely for the refraction and we append a GY modifier but we never have our patients sign an ABN. Is this required?

    Thank you,
    GY - "Item or service statutorily excluded or does not meet the definition of any Medicare benefit."

    These are the so-called "statutory exclusions" or "categorical exclusions" and the "technical denials." ABNs are not an issue for these services. If you know that these services are statutorily excluded then you are using modifier GY correctly and no ABN is required.

  3. Default
    You also would not have to report the refraction at all on the claim UNLESS the patient demands that you do. Sometimes they have another source of reimbursement for these non-covered charges, or use for tax purposes.

  4. #4
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    or if the patient has a vision plan, you can bill the 92015 to the vision plan after you get the denials from primary &/or secondary insurances.
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

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