Thursday, July 15, 2010

Modifier G1,G2,G3,G4,G5,G6 Level-2 modifiers

LEVEL II MODIFIERS G1-G6

Description :
G1  Most recent Urea Reduction Ratio (URR) of less than 60%
G2  Most recent URR of 60% to 64.9%
G3  Most recent URR of 65% to 69.9%
G4  Most recent URR of 70% to 74.9%
G5  Most recent URR of 75% or greater
G6  ESRD patient for whom less than seven (7) dialysis sessions have been provided in a month

Required for Claims :  End-Stage Renal Disease (ESRD) Facilities
Type of Bill: 72X

Coding Guidelines :
The appropriate modifier must be reported when using HCPCS code 90999.

General Guidelines

A) All hemodialysis claims must indicate the most recent Urea Reduction Ratio (URR) for the dialysis patient.

B) Claims for dialysis treatments must include the adequacy of dialysis dated measured by URR. Dialysis facilities must monitor the adequacy of dialysis treatments monthly for facility patients. Home hemodialysis and peritoneal dialysis may be monitored less frequency, but not less than quarterly.

C) The techniques to be used to draw the pre- and post-dialysis blood urea nitrogen samples are listed in the national Kidney Foundation Dialysis Outcomes Quality Initiative Clinical Practice Guidelines for Hemodialysis Adequacy, Guideline 8, Acceptable Methods for BUN sampling, New York, National Kidney Foundation,
1997, pp. 53-60.


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