AMA CPT® Assistant - 2001 Issue 6 (June)
Deletion of the HCFA HCPCS Codes A9160, A9170, and A9190 and the GX Modifier, and Replacement with New Codes and Modifiers; Status Change to HCPCS Cod
June 2001 pages 8-9 Coding Update Deletion of the HCFA HCPCS Codes A9160, A9170, and A9190 and the GX Modifier, and Replacement with New Codes and Modifiers; Status Change to HCPCS Code A9270 To allow providers and suppliers to bill Medicare in order to get denials for secondary payers for noncovered items and services, the following coding changes will become effective January 01, 2002: Deleted Codes A9160 - Non-covered service by podiatrist A9170 - Non-covered service by chiropractor A9190 - Personal comfort item, (non-covered by Medicare statute) Deleted Modifier GX - Service not covered by Medicare Status Changed to...
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Article Overview
This article covers a HCPCS coding update from June 2001 focused on Medicare billing changes effective January 1, 2002. It explains the transition from deleted HCFA HCPCS codes and a deleted modifier to new HCPCS codes and modifiers, along with related claim-reporting and documentation guidance. The piece is relevant to billing staff, coders, providers, and suppliers who need to understand Medicare’s handling of noncovered or not reasonable and necessary items and services.
Why This Topic Matters
The update affects how claims are reported when services or items are expected to deny for secondary payer purposes or are otherwise not covered under Medicare policy. It also clarifies the documentation and claim-narrative framework associated with the new identifiers.
Article Sections
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June 2001 pages 8-9
Introductory coding update identifying the publication date and scope of the Medicare HCPCS changes discussed in the article.
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Deleted Codes
A list of HCPCS identifiers that were removed from use and replaced by other reporting options.
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Deleted Modifier
A modifier identified for deletion as part of the coding update.
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Status Changed to "Not Valid for Medicare"
A code whose Medicare status changed under the update.
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Added Codes
New HCPCS codes introduced for use in the updated Medicare reporting process.
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Added Modifiers
New HCPCS modifiers introduced in connection with the updated reporting framework.
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Explanatory Information to be Included
Documentation and narrative submission guidance associated with the new codes and modifiers.
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Items and Services Considered Not Reasonable and Necessary
General policy discussion of claims involving items or services considered not reasonable and necessary under Medicare rules.
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Statutorily Non-Covered Items or Services
General policy discussion of items or services that are excluded from Medicare coverage by statute.
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Use of the GA Modifier with the New Codes and Modifiers
Guidance discussing how a separate modifier relates to the new coding framework and beneficiary notices.
What You Will Learn
- How the article frames the Medicare HCPCS update effective in 2002
- Which broad categories of identifiers were deleted, added, or changed in status
- What types of documentation and narrative requirements accompany the update
- How the article discusses claims involving noncovered and not reasonable and necessary items and services
- Which Medicare claim-processing topics are addressed in the guidance
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Healthcare providers
- Suppliers of medical items and services
Codes Discussed
Modifiers Discussed
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