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[91] Finally, the presence of CO in the blood is considered responsible for severe anatomical and morphological changes in the myocardium, such as partial or total necrosis of muscle fibrils, and degenerative processes in the mitochondria

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While the KX modifier indicates that the services are medically necessary, the GY modifier (along with three other HCPCS denial modifiers) serves to indicate that a service is not covered because it is outside of the scope of Medicare coverage authorized by the statute

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