Wiki KX modifier for Screening Colonoscopies when to add, when not to add??

[jessirussell2003]

So, I am just learning about this modifier and sort of confused with the wording on Gastro.org. Can anyone clarify when to use this modifier. Also, if the pt is a screening that turns diagnostic so we would use the PT mod would we still use the KX modifier, and which would go first if they were both used. Sorry for so many questions, but my head just rambles question after question. I want to say thank you in advance your your help and advice. Jessica

 

[surfergirl]

This is what I found:

Providers must append modifier KX (“requirements specified in the medical policy have been met”) to HCPCS codes G0105 and G0121 when the screening colonoscopy follows a positive result from one of the following non-invasive stool-based CRC screening tests:

• Screening Guaiac-based Fecal Occult Blood Test (gFOBT) (CPT 82270)
• Screening Immunoassay-based Fecal Occult Blood Test (iFOBT) (HCPCS G0328)
• Cologuard™ – Multi-target Stool DNA (sDNA) Test (CPT 81528)

If the colonoscopy turns into a Diagnostic No do not use modifier KX: If you remove polyps during a screening colonoscopy following a positive non-invasive stool-based test, report the appropriate CPT code (e.g., 45380, 45384, 45385, 45388) and add modifier PT (colorectal cancer screening test; converted to diagnostic test or other procedure) to each CPT code for Medicare.

Was there a positive result from one of the tests? That is the only Time you would use the KX Modifier.

Hope this was helpful