tci General Surgery Coding Alert - 2001 Issue 7

HCFA Briefs: New Modifiers Introduced

HCFA has deleted modifier -GX (service not covered by Medicare) and replaced it with two new modifiers, one of which makes surgeons responsible for deciding if the procedures they perform may not be considered "reasonable and necessary" by Medicare. Two new codes, Q3015 (item or service statutorily non-covered, including benefit category exclusion [use only when no specific code is available]) and Q3016 (item or service not reasonable and necessary [use only when no specific code is available]), have also been added to HCPCS.  According to an April 26 Medicare transmittal (B-01-30), modifier -GX has been replaced by modifiers...

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