By recei ABN –Advance Beneficiary Notice:
An Advanced Beneficiary Notice or Waiver of liability is a notice given by a provider to the patient before rendering service when
the provider feels that the service is not going to be paid by Medicare as per its guidelines and patient may be liable to pay for the service.
GA Modifier
Providers need to Append GA modifier for the item or service when insurance company wants the physician to present an ABN. This GA modifier indicates that patient has signed the ABN and will pay for services taken if not covered by carrier.
GX Modifier
Providers need to Append GX modifier for the item or service when a voluntary Advance Beneficiary Notice is issued to a beneficiary for any services not covered by Medicare.
GY Modifier
Some of the services like cosmetic surgery, vision care, dental care, acupuncture are excluded by Medicare. In that case we report those services with GY Modifier to indicate those services are excluded.
GZ Modifier
If ABN not obtained for the CPT, then it should be billed with GZ modifier, when you know those CPT will be denied as not medically necessity by Medicare.
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