[HEATHER]

Can anyone, in laymans terms, explain to me when you use the GX vs the GA modifier as of 4-1-10? I am having a hard time grasping what is meant by a "required" vs. a "voluntary" issuance of an ABN. I just don't know when an ABN is required? I also know there is some verbiage that would indicate that use of one will trigger an automatic denial whereas the other does not? Anyone who has a firm grasp/examples - I would greatly appreciate any clarification. Thanks!

[DeeDee]

Heather,

We have that on our list of questions for the Jurisdiction B training that we are attending this Thursday. I will be happy to pass along any information that we receive.

[HEATHER]

That would be great! Thank you!

Does anyone know of an example of a "required ABN"?

It is my understanding that if you use a GA modifier (required use of ABN)
they will automatically deny the claim and make it the patient's
responsibility.

If you use the GX (voluntary use of ABN), they will "return the claim to
you" if it is used on the same claim line as "covered equipment." By
"covered" do they mean normally covered? Or do they mean covered for that
particular patient on that particular date of service?