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Modifier PT on all procedures (?)

  1. #1
    Default Modifier PT on all procedures (?)
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    I am aware that the new 2011 PT modifier is to be used to identify a screening that turned into a therapeutic procedure with the screening V76.51 as primary diagnosis.

    My question is one step further;
    The colonoscopy is a screening, there are polyps found and removed by different techinques in different areas (decending by snare 45385), (transverse by forcep 45380) & (ascending by hot bx 45384).

    45385, 45384-59 & 45380-59

    Do I append the PT modifier to all three procedure codes?
    45385-PT, 45384-PT-59 & 45380-PT-59

    Diagnosis; primary on all as screening V76.51, followed by polyp 211.3 as secondary.

    Thanks for your response(s).


  2. #2
    45385 PT
    45384 59, PT
    45380 59, PT

    Got two modifiers? If one is a pricing modifier (example: 26), it goes first. If the other is a statistical modifier (example: 76), put it in the second position.

  3. #3
    Default Modifier PT on all procedures (?)
    Thank you for your response.

    1st - So you agree that the PT modifier should be placed on all three lines?

    2nd - The PT modifer could be considered a paid modifier; as some plans waive copay / deductibles for screening services. It was my understanding that was the main use for this modifier (?)

    Please let me know what you think.


  4. #4
    should the PT modifier be used for any finding, such as diverticulosis 562.10? or would you just not code the 562.10 and leave the v76.51 as the only code?

  5. #5
    You would code the V76.51 primary and then 562.10 secondary. Because Pt is for a screening that turned diagnostic.

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