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Podiatry Coding & Billing Alert

Modifiers:

Modifier GZ Denials Will Arrive Faster, Thanks to New CMS Transmittal

Published on Fri Feb 11, 2011

No more 'complex medical review' for these non-covered services.Most of the time, when Medicare payers process denials in a speedy fashion, that's bad news for your practice -- but when you're using modifier GZ, you are already expecting a denial. CMS has made that happen faster with a new regulation indicating that all claims with modifier GZ appended will be denied immediately.Background on why you'll use GZ: It happens to even the best-run medical practices -- the physician has just performed a noncovered service (such as routine foot care in the absence of a systemic condition) and there's no ABN on file.If you should have had a patient sign an advance beneficiary notice (ABN) but failed to do so, you should append modifier GZ (Item or service expected to be denied as not reasonable and necessary) to the CPT code describing the noncovered service the physician provided. The advantage to reporting modifier [...]
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