Wiki Screenings/Modifiers

Create Wiki
M

meghanb413

New
Messages
8
Location
Westfield, MA
Best answers
0
Just looking for clarification on modifier 33 as I'm hearing and reading contradicting things.

If a patient [with commercial insurance] comes in for a screening/surveillance should modifier 33 be appended or no?

https://www.aapc.com/blog/84107-code-colonoscopies-with-precision/#Coding Colonoscopies

above states append modifier 33 to indicate preventative services [which is what I thought], but I'm now being told otherwise.
 
33 is used when a screening becomes a diagnostic exam, meaning if a patient comes in for a screening, but the colonoscopy ends up being a biopsy or polypectomy, you add the 33 modifier to the claim to indicate the patient's colonoscopy was planned as screening but became something else.
 
coderbeth said:
33 is used when a screening becomes a diagnostic exam, meaning if a patient comes in for a screening, but the colonoscopy ends up being a biopsy or polypectomy, you add the 33 modifier to the claim to indicate the patient's colonoscopy was planned as screening but became something else.
Click to expand...
See but this contradicts the AAPC article I attached saying 33 should be appended to 45378 for commercial insurances.

1687788393029.png
1687788449909.png
 
Hi there, report modifier 33 for a screening exam. Medicare and some private payers want modifier PT when a screening exam converts to a diagnostic service.
 
meghanb413 said:
See but this contradicts the AAPC article I attached saying 33 should be appended to 45378 for commercial insurances.
Click to expand...
Can you supply the URL for this AAPC article? I've only been appending (like other) a modifier when the screening turns therapeutic. I believe you are stating that if the 45378 is used for a commercial screening, Mod 33 should be added. Thank you.
 
You must log in or register to reply here.
Top