Physician Practice

Be gone, dangling modifiers

Physician Practice Perspective, May 21, 2002

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Practices must include the GA modifier on claims anytime patients sign an advance beneficiary notice, or they’ll risk fraud and abuse trouble, according to new modifier guidelines the Centers for Medicare & Medicaid Services (CMS) released in March. For ex ample, use the GA modifier for an assigned claim when patients won’t sign the notice, but you perform the service anyway. (Use the GZ modifier, under these circumstances, but for unassigned claims.) Carriers will not consider GA modifiers in their decisions to deny or pay claims. Patients are responsible for payment w

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Physician Practice Perspective.

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