Medical Billing Forum

Coding => Coding => : WandeeM May 09, 2012, 06:12:37 PM

: Coding/ Chiropractic
: WandeeM May 09, 2012, 06:12:37 PM
I am new to billing for Chiro care. My question is on the HCPCS modifiers. In our office we have all Medicare patients sign an ABN but I am not sure which HCPCS modifier to apply to the procedure codes for instance if we have an ANB on file and we know that Medicare will not pay for procedure code should we apply -GA or -GY. If anyone can shed light on this I would be over joyed.
: Re: Coding/ Chiropractic
: DMK May 09, 2012, 06:52:15 PM
GA indicates that you have an ABN on file and that the patient knows they will have to pay for the service, and that Medicare doesn't pay for the service.  This will generate an EOB showing that the patient IS liable for paying for the service.

GY indicates that you know that this is a non-covered service, and you won't be charging the patient for it.