Screening Colonoscopy and Anestheisia

cmotard

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Screening Colonoscopy and Anesthesia

If a patient is having a screening colonoscopy G0121, G0105, or 45378-33. Lets say a non-medicare patient was coded with a G0121 and DX Z12.11. G0121 is accepted by most commercial insurance companies so this should be fine. When its time to bill anesthesia you would use 00810 with a 33 modifier, correct? The anesthesia coding would be the same if you billed that same patient with 45378-33, right? I want to make sure a non-medicare patient billed with G0121 would still have a 33 modifier when billing anesthesia since we need to show that the reason for the anesthesia was for screening purposes.

G0121 DX Z12.11, Anesthesia - 00810 - AA, 33, QS (as long as anesthesia was administered by an anesthesiologist)

Let's say this same patient had a physical status modifier - P3

Would the order of the anesthesia modifiers be AA, 33, QS, P3 or P3, AA, 33, QS?

Any information would be greatly appreciated!
 
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bwolfe1

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If a patient is having a screening colonoscopy G0121, G0105, or 45378-33. Lets say a non-medicare patient was coded with a G0121 and DX Z12.11. G0121 is accepted by most commercial insurance companies so this should be fine. When its time to bill anesthesia you would use 00810 with a 33 modifier, correct? The anesthesia coding would be the same if you billed that same patient with 45378-33, right? I want to make sure a non-medicare patient billed with G0121 would still have a 33 modifier when billing anesthesia since we need to show that the reason for the anesthesia was for screening purposes.

G0121 DX Z12.11, Anesthesia - 00810 - AA, 33, QS (as long as anesthesia was administered by an anesthesiologist)

Let's say this same patient had a physical status modifier - P3

Would the order of the anesthesia modifiers be AA, 33, QS, P3 or P3, AA, 33, QS?

Any information would be greatly appreciated!


Code modifiers in order of pricing information: Provider type, Anesthesia type, physical status. So AA, QS, P3. The screening modifier -33 is for the physician. Insurance will note "screening" from the physician's claim. "Most" anesthesia claims are not paid until the physician's claim has been received.
 

amyce2693

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A non-medicare patient doesn't use the G codes and you wouldn't use a modifier with a G code. You would code this procedure as 45378. If there was an additional procedure done say a polypectomy with a cold forcep, then you would code 45380-33. The modifier is used to show it was a screening and then work had to be done. If it was a medicare patient, you would code this as 45380-PT. There shouldn't be a modifier used if nothing was done, ie 45378.
 
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