GY - JE Part A
Modifier GY
Definition
Item or service statutorily excluded, does not meet the definition of any Medicare benefit.
Appropriate Usage
- Append when services are provided under statutory exclusion from Medicare Program; claim would deny whether or not modifier is present on claim
- It is not necessary to provide patient with an ABN for these situations
- Situations excluded based on a section of the Social Security Act
- Non-covered ambulance mileage reported on HCPCS A0888
- Append to cause claim to deny with patient liable for charges
Inappropriate Usage
- Appending to bundled procedures
- Appending to add-on codes
Resource
Last Updated Dec 16 , 2022
