Auto Denial of Claim Line(s) Items Submitted With a GZ Modifier
This CR requires that all MACs, CERT, RACs, PSCs and ZPICs shall automatically deny claim line(s) items submitted with a GZ modifier. Contractors shall not perform complex medical review on claim line(s) items submitted with a GZ modifier. All MACs shall make all language published in educational outreach materials, articles, and on their Web sites, consistent to state all claim line(s) items with a GZ modifier shall be denied automatically and will not be subject to complex medical review.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 04, 2011
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