Modifiers used with HCPCS Codes

Thanks to two modifiers, at least one aspect of dealing with ABN forms is about to get a bit easier. CMS now offers you two HCPCS Level 2 modifiers to distinguish between voluntary and required uses of liability codes.

Know when you require an ABN with this piece of advice

When your physician provides a service that Medicare does not cover, your practice must provide an ABN to the patient. The patient should then examine and complete the form before your providers administer that service or procedure.

When you have a patient sign an ABN, you also need to use the right modifiers on your claim. ABN modifiers inform the Medicare carrier that you have an ABN on file for services that will not be covered.

Fortunately, modifiers GA and GX should add more tools to your belt that’ll help you fend off denials.

Do not waver on modifier GA use

Centers for Medicare & Medicaid Services redefined modifier GA to be a waiver of liability statement. You should only append modifier GA to report when a required ABN was issued for a service and shouldn’t be reported in association with any other liability-related modifier and should continue to be submitted with covered charges.

For more on this and for further information on modifiers used with HCPCS code, sign up for a one-stop medical coding website. When you get onboard such a site, you will get a thorough and detailed description of an individual CPT, HCPCS and ICD-9 code along with all HCPCS modifiers.