Wiki GW Modifier

[bethh05]

I have a claim being denied by Medicare and the physicians office has been reimbursed, they had to use the GW modifier. Is this modifer ASC approved? If it is not, any suggestions on how I can get the claim paid. Thanks alot!!!

 

[mbort]

can you tell us what codes you billed, with what modifiers ect?

 

[bethh05]

11646 and 12054 were billed with Dx:173.3. The previous coder/biller used modifier 59 and 51 on the second line, but I took those off the corrected claim.

 

[mbort]

the GW modifier is for physicians, not for ASC's so that gets tossed out the window.

Have you checked the LCD's for those codes for your area? What is the denial Medicare is giving you?