PT vs 33 modifier

ChristineA

Networker
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48
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Is the PT modifier only for medicare patients? A patient called today and said BC/BS told her that she would need to tell our office when we bill her for her colonoscopy that we need to use the PT modifier. Is this correct?
 

Lindseywingate1990

Networker
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61
Location
Lake View, Alabama
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PT is a Medicare modifier and should be used when billing to Medicare. i would use modifer -33 when sending to BCBS or look at the policy on the web site on how they want it to be billed.
 

normal660

New
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PT modifier

The PT is for Medicare. The 33 is for other commercial. However BCBS claims if I was using the 33 is is not recognized so after contacting BCBS they indicated that they need no modifier as the screening diagnosis will tell that the service is a preventative service
 

EricaR

Networker
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63
Location
Atlanta Perimeter
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There is information available in regards to this. Specifically this is bcbs of GA but you should be able to find something like this or contact your provider reps.

I recently started adding modifier -PT and -33 to BCBS cscopes. So far all have processed no problems.


http://www.bcbsga.com/shared/noapplication/pressroomwlp/nosecondary/notertiary/pw_b157212.pdf?refer=chpproviderbcbsga

http://www.bcbsga.com/shared/noapplication/pressroomwlp/nosecondary/notertiary/pw_b157422.pdf?refer=chpproviderbcbsga
 

eescalante

Networker
Messages
59
Location
Atlanta Perimeter
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BCBS of Georgia recognizes the PT modifier for colonoscopy, flex sig, etc. We have been using it successfully. However, BCBS plans from other states do not always use it.
 
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