- Dental Services
- Dental Services
- Enrolling in Medicare
- Medicare Coverage Exclusion: Dental Services
- Claim Submission Guidelines
- Medical Documentation Requirements
- New Medicare Provider
- Additional Development Request Letters Guide
- Medicare Coverage Exclusion: Dental Services
- Inpatient Services in Connection With Dental Procedures
- The Utilization of the KX Modifier on Dental Claims
- Modifier GY
- Standard Companion Guide Health Care Claim: Dental (837D)
- 837D Edit Spreadsheet
- Dental Claim Cross Over
- Attention Clearinghouses and Vendors!
- Resources
Modifier GY
Providers should be aware of the guidelines for submitting the noncovered outpatient dental service for a denial when the patient has supplemental insurance or if a denial is needed for any other reason.
Modifier GY is reported when submitting a Medicare claim for the statutorily excluded service in order to receive a formal denial for purposes of billing the supplemental insurance company.
Additionally, the modifier “GY” must be appended to a service(s) when the item or service is included on a claim and is statutorily excluded or does not meet the definition of any Medicare benefit.
Reviewed 6/26/2024