Results 1 to 4 of 4

PT Modifier - CMS

  1. #1
    Default PT Modifier - CMS
    Medical Coding Books
    Does anyone have any information on the use of the PT modifier for screening procedures (GI) as of 1/1/11. I am unable to locate anything on CMS and a lot of our commercial payers & Medicare managed care plans know nothing about this modifier. Any help is appreciated. Thanks,

  2. #2
    The PT modifier information is located in the MLN Matters number MM7012 release date 07/30/10. Not sure if that helps or not. The good thing is that if the patient comes in for a screening colon and then becomes diagnostic, append the PT modifier and the deductible and the co-ins are still waived as if it were a screening.

  3. #3
    from what i understand it is only the deductible that is waived, not the coinsurance

  4. #4
    Columbia, MO
    That is correct it is the deductible that is waived.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Modifier PT for Colonoscopy being denied by CMS
    By Billing500 in forum Anesthesia
    Replies: 5
    Last Post: 02-23-2015, 09:11 PM
  2. Modifier 79 and 20611 not allowed per CMS?
    By in forum Modifiers
    Replies: 0
    Last Post: 02-20-2015, 09:46 AM
  3. Modifier -59 rejection by CMS
    By rcoslett in forum Modifiers
    Replies: 0
    Last Post: 05-08-2013, 03:55 PM
  4. PT Modifier - CMS
    By sbarrila in forum Gastroenterology
    Replies: 5
    Last Post: 12-05-2011, 09:49 AM
  5. CMS modifier PT
    By Ruth A. Robillard in forum Medicare Regulations
    Replies: 0
    Last Post: 01-27-2011, 07:48 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.