USAGE of Modifier 52 – Reduced services

When To Use Modifier 52 Modifier 52 Reduced Services; is used when a service / procedure was not completed in its entirety. You must review all documentation with the physician. Modifier 52 pertains to opening and closing of a procedure. Some clinics and surgery...

Modifier GZ – medical necessity denial

Modifier GZ Fact Sheet Definition: • The provider or supplier expects a medical necessity denial; however, did not provide an Advance Beneficiary Notice (ABN) to the patient. Example: The medical reason for performing this test does not meet medical necessity and the...