AAPC - Back to school
Results 1 to 2 of 2

Thread: Medicare CRC Screening: Diagnostic Modifier-PT

  1. #1
    Join Date
    Apr 2007

    Post Medicare CRC Screening: Diagnostic Modifier-PT

    AAPC: Back to School
    Does this mean that MCR will pay at the lower rate of just a screening? And do we use this modifier with all insurance companies or just Medicare?

  2. #2


    No this means if you perform a polypectomy etc. on a patient who presented for a screening colonoscopy the Medicare deductible will be waived. Under the Affordable Care Act if they only have a screening colon G0105, or G0121 then they have the deductible and coinsurance waived. This way the patients who have a polyp etc found will also benefit from the waived deductible. We have problems with our carrier processing 45385 etc. with a V code so we have no way of indicating when the patient presented for a screening that turned diagnostic.

Similar Threads

  1. Medicare Screening colonscopy turned diagnostic
    By Sephardic in forum Gastroenterology
    Replies: 5
    Last Post: 04-04-2012, 08:11 AM
  2. screening vs diagnostic
    By kjarrells in forum Gastroenterology
    Replies: 17
    Last Post: 12-06-2011, 01:13 PM
  3. screening or diagnostic
    By heldermanb in forum OB/GYN
    Replies: 1
    Last Post: 09-22-2011, 08:52 PM
  4. Replies: 9
    Last Post: 03-09-2011, 08:11 PM
  5. Screening vs diagnostic
    By KIMBERLY44 in forum Gastroenterology
    Replies: 4
    Last Post: 04-28-2009, 01:43 PM

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.