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I work in a GI clinic, and we use modifier 33 and modifier PT all of the time. I am now getting claim rejections for these modifiers, that the procedure codes we are using are inconsistent with the modifier used. How are we to let insurances know that these are preventative services?
 
I work in a GI clinic, and we use modifier 33 and modifier PT all of the time. I am now getting claim rejections for these modifiers, that the procedure codes we are using are inconsistent with the modifier used. How are we to let insurances know that these are preventative services?
What are the procedure codes that you are using with modifier 33?
 
What are the procedure codes that you are using with modifier 33?
We use all the colonoscopy/EGD CPT codes, and also E/M codes, but I have noticed that, only recently, that I am unable to use modifier 33 on E/M codes, though earlier this year, the previous biller for this office was using modifier 33 on E/M codes. I only took over billing here a few months ago, and my previous experience was with PT and Respiratory. I must be missing something.
 
Modifier 33 indicates a procedure started as a screening and turned diagnostic. It is not to be appended to E/M codes. 24, 25, 57, 95 are all acceptable E/M modifiers. 33 doesn't appear on the list in my Encoder.
 
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