Which modifier indicates that the patient forgot to have the patient sign an ABN?

• A. GA
• B. GX
• C. GY
• D. GZ

Answer: (D)

Medicare uses ABN modifiers to show what happened with the Advance Beneficiary Notice. When a service might not be covered, an ABN is offered. If the patient signs the ABN, you mark that liability is waived because the ABN is on file. If the ABN was not obtained—meaning the patient did not sign one or you forgot to get it—you use the modifier that indicates no ABN is on file. In this scenario, the situation described is that an ABN was not obtained because the patient forgot to sign, which is represented by that modifier. The other modifiers relate to different ABN situations (such as having an ABN signed or other non-coverage scenarios), but they do not indicate missing or unsigned ABN.