HCPCS 'G' Modifiers (34)

Modifier Description
G1 Most recent urr reading of less than 60
G2 Most recent urr reading of 60 to 64.9
G3 Most recent urr reading of 65 to 69.9
G4 Most recent urr reading of 70 to 74.9
G5 Most recent urr reading of 75 or greater
G6 Esrd patient for whom less than six dialysis sessions have been provided in a month
G7 Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening
G8 Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure
G9 Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
GA Waiver of liability statement issued as required by payer policy, individual case
GB Claim being re-submitted for payment because it is no longer covered under a global payment demonstration
GC This service has been performed in part by a resident under the direction of a teaching physician
GD Units of service exceeds medically unlikely edit value and represents reasonable and necessary services
GE This service has been performed by a resident without the presence of a teaching physician under the primary care exception
GF Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
GG Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day
GH Diagnostic mammogram converted from screening mammogram on same day
GJ "opt out" physician or practitioner emergency or urgent service
GK Reasonable and necessary item/service associated with a ga or gz modifier
GL Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
GM Multiple patients on one ambulance trip
GN Services delivered under an outpatient speech language pathology plan of care
GO Services delivered under an outpatient occupational therapy plan of care
GP Services delivered under an outpatient physical therapy plan of care
GQ Via asynchronous telecommunications system
GR This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy
GS Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level
GT Via interactive audio and video telecommunication systems
GU Waiver of liability statement issued as required by payer policy, routine notice
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary