HCPCS Modifier GX

Description
Notice of liability issued, voluntary under payer policy.

Guidelines

  • This modifier is effective for services provided on or after January 1, 2011
  • Submit this modifier if you have voluntarily obtained a valid Advance Beneficiary Notice of Noncoverage (ABN). This includes ABNs obtained for services that are statutorily denied, such as physical therapy services provided by chiropractors. You may, but are not required to, ask patients to sign ABNs for services that are statutorily denied.
    • Part B services will not automatically be denied when submitted with HCPCS modifier GX
    • Part A services will automatically be denied when submitted with HCPCS modifier GX
  • You may report this modifier in addition to HCPCS modifiers GY and TS
  • You may not report this modifier in addition to the following HCPCS modifiers: EY, GA, GL, GZ, KB, QL and TQ. Palmetto GBA will return as unprocessable any claims submitted with HCPCS modifier GX plus one of these modifiers with remark code MA130.

References

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 

Click to Chat Now