CMS Makes Key Changes to ABN Modifiers

No foolin'. We'll use new ABN modifiers on April 1st.

We’ve got the new instructions you’ll need to follow.

CMS will update the ABN modifiers effective April 1, according to MLN Matters article MM6563, dated Oct. 29.

The ABN descriptors will read as follows:

• Modifier GA — Revised to read, “Waiver of liability statement issued as required by payer policy.” You’ll use this when a required ABN was issued.
• Modifier GX — New modifier 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.

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