Update on Elastic Spinal Garments

Effective for claims with dates of service on or after April 1, 2009, if a spinal garment billed with one of the preceding HCPCS codes is made primarily of elastic material, the supplier must add the GY modifier to the code and the claim line will be denied as noncovered, no benefit category. If a spinal garment billed with one of the preceding codes is made primarily of nonelastic material (e.g., cotton or nylon) or has a rigid posterior panel, the supplier must add the CG modifier (policy criteria applied) to the code. If the CG or GY modifier is not used with one of the preceding HCPCS codes, it will be rejected/denied as incorrect coding.

For more information, please click here   Spinal Elastic Garments

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Categories: Customer Information, Medicare

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