ABN Modifiers

Question 1

-GA

Answer 1

ABN is signed and the claim form includes covered and no covered services.

Report when you issued a MANDATORY ABN for a service as required and it is on file you do not need to submit a copy of the ABN but you must have it available on request. The modifier is used when both covered and noncovered services appear on an ABN related claim

Question 2

-GX

Answer 2

When a voluntary ABN is assigned for a statutorily noncovered service.

Report when you issue a VOLUNTARY ABN for service Medicare never covers because it is statutorily excluded or is not a Medicare benefit you may use this modifier combine with modifier -GY

Question 3

-GY

Answer 3

Identifies a service that is statutorily excluded as a Medicare benefit.

Report that Medicare statutorily excludes the item or service, or the item or service does not meet the definition of any Medicare benefit. You may use this modifier combine with modifier -GX

Question 4

-GZ

Answer 4

When an ABN was not signed and the services are expected to be medically unnecessary.

Report when you expect Medicare to deny payment of the item or service because it is medically unnecessary and you issued no ABN