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1.   A GA, GZ, GY or KX modifier can be added to any claim to show the medical necessity is met per the Local Coverage Determination (LCD)?

True
False


2.   As specified in the policy, if the KX modifier is omitted on the claim, you may call re-openings to have it appended to the claim?

True
False


3.   Proper use of the KX modifier expedites claim processing?

True
False


4.   The presence of the KX modifier indicates you do not have the documentation to support the medical necessity?

True
False


5.   If a claim denies not medically necessary for an item in which an ABN was obtained, a GA modifier will cause the liability to change from Contractual Obligation (CO) to Patient Responsibility (PR).

True
False


6.   If a supplier has properly obtained an ABN, which of the following modifiers would be applied to the claim line for the HCPCS code in question?

GY
GZ
GA


7.   What modifier is used to indicate a statutorily noncovered item, such as tub rail or stair lift?

GA
GZ
GK
GY


8.   If there is a KX modifier requirement in a specific policy claim lines billed without a KX, GA or GZ modifier will be rejected as missing information.

True
False


9.   When there is an expectation of a medical necessity denial, suppliers must enter the __ modifier on the claim line if they have not obtained a properly executed Advance Beneficiary Notice (ABN).

GA
GY
GZ


10.   Proper use of the GY modifier may cause a claim to auto-deny as noncovered.

True
False


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12/01/2009

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