Modifier GX

Definition

Voluntary liability notice was issued.

The GX modifier is used to report that a voluntary Advance Beneficiary Notice of Noncoverage (ABN) has been issued to the beneficiary before/upon receipt of their Part B procedure/service because it is statutorily noncovered or does not meet the definition of a Medicare benefit.

Correct Use

  • Append when services are submitted with non-covered charges only
  • Append when the definition is "Notice of Liability Issued, Voluntary Under Payer Policy" and is to be used to report when a voluntary ABN was issued for a service
  • May report GX in combination with GY modifier.

Incorrect Use

  • Do not append to claims when an ABN has not been issued
  • Do not append to claims for items that are not considered statutorily excluded or that meet a defined benefit category

Resource

 

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