Neurosurgery Coding Alert

If you started coding many years ago, you might remember using modifier GX for noncovered services. You'll have a new modifier GX to start reporting later this spring, but it has an all-new descriptor and all-new rules.

What's new: CMS will update two advance beneficiary modifier (ABN) modifiers effective April 1, according to MLN Matters article MM6563. The ABN descriptors will read as follows:

• Modifier GA will change from "Waiver of liability statement on file" to "Waiver of liability statement issued as required by payer policy." You'll use this when your practice issued a required ABN.

• All-new modifier GX will be defined as "Notice of liability issued, voluntary under payer policy." You'll append this modifier to claims when you've issued a voluntary ABN.

Currently, you can append modifier GA when you issue the ABN for either required or voluntary reasons, says Zia Clarkson, a coding, reimbursement, and practice management consultant in Long Island, N.Y.

Keep in mind: When you know an item is statutorily non-covered, you don't have to issue an ABN and submit the claim to your carrier with a modifier appended, but you can.

You can collect for these services at the time of the visit, says Shelly M. Kirk, CPC, with Tennessee Orthopaedic Clinics in Knoxville.

For more on the new ABN modifiers, visit www.cms.hhs.gov/MLNMattersArticles/downloads/MM6563.pdf.