DecisionHealth, DecisionHealth - 2011 Issue 3 (March)

GZ modifier claims to auto-deny starting July 1

Your practice will soon have one more good reason to make sure you get the patient to sign an advance beneficiary notice (ABN) if you think a claim doesn’t meet your carrier’s medical necessity requirements. Starting July 1, CMS has given its contractors discretion to auto-deny claims that arrive with the GZ modifier, which indicates that the claim may not meet medical necessity rules and that the patient did not sign an ABN.

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