tci Medicare Compliance & Reimbursement - 2021 Issue Q1

Ace ABNs With G-Modifier Mastery

One of the obstacles associated with submitting advance beneficiary notices (ABNs) to Medicare is attaching the G modifier that matches the case specifics. Why? You have a choice of four G modifiers to use with your claims, depending on the payment situation, that explain to your insurer whether an ABN is on file, and if so, why. “CMS has provided communications regarding the use of G modifiers. These modifiers are recommended to be used to help ensure the proper processing of the claim,” explains Cynthia A. Swanson, RN, CPC, CEMC, CHC, CPMA, of ClaimDOC in Des Moines...

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