Billing and Coding: 3 Medicare Modifiers To Be Aware Of

Welcome to your billing and coding weekly solutions by H.J.Ross Company where getting your bills paid is what we do best!

Are your Medicare claims being denied because of incorrect modifiers? Medicare has modifiers essentially unique to Medicare and as an HJ Ross Network member you would know exactly which modifiers to use and when.

Here are 3 Medicare modifiers to be aware of:

Modifier GY: Modifier GY is required on any service other than spinal manipulation. This modifier indicates an excluded service from Medicare reimbursement for chiropractic claims.

Modifier GA: Modifier GA is for spinal manipulation considered maintenance or non-payable by Medicare and that the patient has signed an Advance Beneficiary Notice (ABN) or waiver.

Modifier GP: Medicare requires Modifier GP on all physical medicine codes, which it does not cover; however, it must be used for patient to receive a proper denial for a secondary payer to make payment.

Did you know 2021 updates to ICD-10 diagnosis codes that will affect your chiropractic claims were updated on October 1, 2020? You would have as a HJ Ross Network client!

This means any date of service or billing on or after October 1st must include the new and revised code or it will be denied.

Billing with incorrect chiropractic CPT codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business. 

If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then H. J. Ross Company is your solution.

H.J Ross Company stays ahead of the curve on the latest trends and changes in billing and coding by utilizing their direct channel of communication with the insurance companies and organizations that set the guidelines.

There is a reason chiropractors have trusted H.J. Ross Company with their business for over 40 years.