tci General Surgery Coding Alert - 2002 Issue 12

Reader Questions: Modifiers -GA and -GX

Question: I've heard that guidelines for Medicare modifiers -GA and -GX have changed. How should I apply these modifiers? Texas SubscriberAnswer: Even when you do not expect Medicare to cover a given service/procedure, you must file a claim with your Medicare carrier. And you must append modifier -GA (Waiver of liability statement on file) to all CPT codes covered by an advance beneficiary notice (ABN). An ABN is a written notice provided by the physician to inform a beneficiary that Medicare may not cover a particular service or procedure and asks the patient to pay. The ABN must clearly...

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