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Modifier 33 - CPT Symposium

  1. Default modifier 33
    Medical Coding Books
    Can anyone please tell me if modifer 33 can be used on capitated patients/plan?

  2. #32
    lovelannd co
    does anyone know if this modifier is needed on anesthesia claims? and if it takes the place of any current required modifiers (QS, GZ)???

  3. #33
    Default modifier 33 anesthesia
    yes as of 1/1/15 it applies to anesthesia I hope the following link will get you to their website.

    Also, I had this sent to me by my supvr.
    Modifiers 33 and PT for colonoscopies-mod 33 is when screening colonoscopy done, no polyp found. Medicare pays 100% of the screening and anesth., no copay, no deductible. Mod 33 is secondary modifier to the anesth mods. Mod PT is when screening is done and a polyp is found. Medicare pay 80% and patient must pay copay; however the pt doesn not have to pay the deductible even if a polyp is found. PT is also a secondary modifier.

    Hope that helps!

  4. Default
    All of our anesthesia claims are being denied by Medicare when billing:
    00810 AA QS PT
    The 33's are being paid correctly, though.

    The "senior CMS rep" has directed me to a January 2015 Release - Part B document which only calls for modifier 33 to be used for anesthesia associated with screening colonoscopy. She further said that only the provider doing the actual colonoscopy should be billing with a PT.

    I've seen many other sites (including some fairly well known anesthesia sites), which list PT as the modifier which should be used in cases where polyps were removed or a biopsy was taken.

    Has anyone else had trouble with denials when using modifier PT?? Please weigh in.

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