DecisionHealth, DecisionHealth - 2014 Issue 6 (June)

CMS 2012 data: Modifier GA doesn’t mean automatic denials

The modifier GA (Waiver of liability on file) indicates that you gave the patient an advanced beneficiary notice of non-coverage (ABN), and you’re only supposed to do that if you have good cause to believe the claim will be rejected – otherwise you could get in trouble for issuing “blanket” notices (PBN 5/6/13). Yet surprisingly, only 21% of codes filed with GA have a 100% denial rate. And some of the codes most often submitted with GA are denied less often than they are without the modifier.

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