Wiki Modifier PT/33

[KoBee]

Hello everyone -

for screening that turned into therapeutic Is modifier PT or 33 be on all codes when multiple interventions are performed

example

45385 - PT
45380 - PT, XS

or

45385 - PT
45380 - XS

would love to know how everyone is else is capturing it.

 

[lamiller]

Hello everyone -

for screening that turned into therapeutic Is modifier PT or 33 be on all codes when multiple interventions are performed

example

45385 - PT
45380 - PT, XS

or

45385 - PT
45380 - XS

would love to know how everyone is else is capturing it.

If this a Medicare plan then yes, PT on 45385 and XS on 45380. I have been getting denials though for BlueCross Medicare Advantage in Tennessee with 45380-XS saying it's bundled.

 

[nickelclaw]

Pt only on MCR types and 33 on all other payers/or payer specific

 

[bench]

Medicare:
45385-PT
45380-PT-XS
Commercial:
45385-33
45380-33-XS

As long as they are different lesions/site. If the same lesion 45385-PT or 33 only.

 

[nsteinhauser]

Do you have any/know of any documentation re: the -33 can be used on more than one colonoscopy on the same dos for commercials? Our Medicare contractor has no problems with the -PT being used on multiple colonoscopies but the commercials send it back.
Thanks!