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Modifiers -PT and -33

  1. Smile Mary Shults LPN-CPC
    Medical Coding Books
    Quote Originally Posted by sbarrila View Post
    The 33 modifier is not used to just indicate when a screening turns diagnostic. The 33 modifier is to be used for preventitive services regardless.
    This is the correct application of the 33 modifier. It is intended to be used for preventative even if the procedure does not turn into a diagnostic one. This is the CPT definition of the modifier.

  2. Default
    Quote Originally Posted by DEDGE CGIC View Post
    High risk indicators should be documented as a routine screening for said history aand billed as a screening for said histori i.e. V76.51, v12.72.

    The modifiers Pt and 33 are only to indicate when a procedure became diagnostic due to findings such as a polyp. Pt is only for medicare and their guidelines are currently very messy for it's use. Currently we have found the only carrier accepting the 33 modifier for it's specified use is Anthem.

    Hope this helps.

    If the pt is medicare HMO than we also have to bill with 33 modifier????

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