G Modifiers

G1

Most recent urr reading of less than 60

G2

Most recent urr reading of 60 to 64.9

G3

Most recent urr reading of 65 to 69.9

G4

Most recent urr reading of 70 to 74.9

G5

Most recent urr reading of 75 or greater

G6

Esrd patient for whom less than six dialysis sessions have been provided in a month

G7

Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening

G8

Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure

G9

Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition

GA

Waiver of liability statement issued as required by payer policy, individual case

GB

Claim being re-submitted for payment because it is no longer covered under a global payment demonstration

GC

This service has been performed in part by a resident under the direction of a teaching physician

GD

Units of service exceeds medically unlikely edit value and represents reasonable and necessary services

GE

This service has been performed by a resident without the presence of a teaching physician under the primary care exception

GF

Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital

GG

Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day

GH

Diagnostic mammogram converted from screening mammogram on same day

GJ

"opt out" physician or practitioner emergency or urgent service

GK

Reasonable and necessary item/service associated with a ga or gz modifier

GL

Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)

GM

Multiple patients on one ambulance trip

GN

Services delivered under an outpatient speech language pathology plan of care

GO

Services delivered under an outpatient occupational therapy plan of care

GP

Services delivered under an outpatient physical therapy plan of care

GQ

Via asynchronous telecommunications system

GR

This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy

GS

Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level

GT

Via interactive audio and video telecommunication systems

GU

Waiver of liability statement issued as required by payer policy, routine notice

GV

Attending physician not employed or paid under arrangement by the patient's hospice provider

GW

Service not related to the hospice patient's terminal condition

GX

Notice of liability issued, voluntary under payer policy

GY

Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit

GZ

Item or service expected to be denied as not reasonable and necessary

 

 

© BestRx Pharmacy Software