GA and GY for Medicare Billing

We are using the ABN for non-covered services (such as therapy codes) when the patient is under active care. We are also using the ABN for CMT codes when the patient is under maintenance care. We are now confused about when to use the modifiers GA & GY when billing CMT & therapy codes. Would you please explain when & why each should be used for Active and Maintenance Care?

Proper Use of Modifiers for Maximum Reimbursement and Reducing Audits

Modifiers are two-digit codes appended to procedure codes and/or HCPCS codes to provide additional information about the billed procedure. In some cases, addition of a modifier may directly affect payment and incorrect use can result in audits and potential recoupment. In this webinar, certified coder and auditor David Klein will review the “do’s” and “don’ts” of proper modifier usage to help maximize reimbursement and reduce the likelihood of an audit.

Everything a Chiropractor Needs to Know About 97110, Therapeutic Exercises

97110, Therapeutic Exercises, is one of the most commonly used CPT codes for Chiropractors. Unfortunately it is also misunderstood and misused far too often. For instance, did you know that it should not be reported with modifier 52, ever? Find out all you need to know about this code in the 2016 ChiroCode DeskBook Common Procedure Codes chapter.

Modifier XE Fact Sheet

Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate Encounter

Coding pairs are part of the National Correct Coding Initiative (NCCI) procedure to procedure edits
Documentation indicates the services were provided during separate patient/provider encounter
Use Modifier XE with the Column 2 procedure code in the NCCI files
Use Modifier XE only when there …