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Use of PT and 33 modifiers with high risk screenings

andreagail

Guest
Messages
10
Best answers
0
Help! I have a patient who was in for a high risk screening due to personal history of colonic polyps. Another polyps was found in the latest colonoscopy. Should I bill this to Cigna with the 45385 with modifier 33 added? Not sure about the use of these modifiers with high risk screenings. Any thoughts anyone?
 

Lindseywingate1990

Networker
Messages
61
Location
Lake View, Alabama
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0
i would use the modifier 33/PT depending wether it is a medicare or commercial carrier but, that does not specify to the insurance wether the patient is at high risk or not i would use the personal history code V12.72 to show the patient is at high risk. hope this helps!
 

coachlang3

True Blue
Messages
532
Location
Charlotte, NC
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0
If it was a snare it would look like this for Cigna:

45385 (CPT)

33 (modifier)

V76.51, 211.3, V12.72 (ICD-9 dx)

Yes I understand the 33 mod along with the V76.51 seem redundant. But that is how you would code your scenario.
 
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