The below provides clarification on the appeal rights (by party to an appeal) for the following:
- Claim has been submitted and processed with a liability modifier(s) but appellant wishes to remove it/them
- Claim has been submitted and processed without a liability modifier(s) and appellant wishes to add it/them, if applicable
Although Reopenings is not an appeal level, it does offer providers the option to request clerical adjustments to their claims.
Modifier | Appeal Rights |
GA | Beneficiary: Yes.
Provider: Yes. - If claim line was submitted and processed as covered, line can be adjusted (including modifier removal)
- If line denied (denies beneficiary-liable), request an appeal
- Note: In certain situations, line-item may deny as provider-liable. An example includes, but is not limited to, a preventive service which does not meet medical necessity (as driven by diagnosis code) and is not subject to frequency edits
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GX | Beneficiary: Yes.
Provider: Yes. - Line-item denied as beneficiary-liable, request an appeal
- Note: Append this modifier to report that a voluntary ABN was issued for a service. Lines submitted as non-covered will deny as beneficiary-liable
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GY | Beneficiary: Yes.
Provider: Yes. - May adjust claim to remove modifier and re-submit as covered. Noridian may review for medical necessity
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GZ | Beneficiary: Yes.
Provider: Yes. - Line-item denied provider-liable, request appeal
- Note: May only request to remove this modifier during redetermination process. Medical records will not be reviewed to determine medical necessity
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