tci Part B Insider - 2011 Issue 3

Medicare Modifiers: Modifier PT: Use This When Colorectal Screening Becomes Diagnostic

New modifier became effective Jan. 1--here's how you'll report it.The question of how to code a screening colonoscopy that becomes diagnostic during the course of the procedure -- and whether the patient's deductible applies -- has long puzzled gastroenterological practices, but a new Medicare modifier solves that problem.Effective Jan. 1, Medicare carriers accept new modifier PT (CRC screening test converted to diagnostic test or other procedure) to represent this scenario. "This tells the MAC contractor that the service started as a screening procedure (e.g. G0105, G0121) but an abnormality was found and the procedure became diagnostic...

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