GY Modifier
Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
HCPCS modifierGY
- Description
- Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
- Short description
- Statutorily excluded
- Added
- January 1, 2002
- Last change
- July 1, 2007
What does the GY modifier mean?
The HCPCS Level II modifier GY means: “Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit”. Append it to a HCPCS or CPT code on the claim line when the payer’s policy calls for it; placement and payment effects are defined by each payer.
Other G modifiers
- G0 – Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke
- 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
- 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
- GZ – Item or service expected to be denied as not reasonable and necessary