tci E/M Coding Alert - 2016 Issue 12

Modifiers: Use G Modifiers to Represent ABN Situation

Medicare uses G modifiers to specify why practice issues ABN. Patients that report to your physician for evaluation and management (E/M) services that Medicare might not completely cover should always be on your advance beneficiary notice (ABN) radar. Once you’ve provided the patient with the ABN, Medicare also asks that you append the proper G modifier. While the G modifiers are not required to garner pay for the services, experts think it’s a good idea to use the modifiers for compliance reasons. G modifiers also make things easier on payers, as they indicate whether you will be...

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