This is what I found:
Providers must append modifier
KX (“requirements specified in the medical policy have been met”) to HCPCS codes
G0105 and G0121 when the screening colonoscopy follows a positive result from one of the following non-invasive stool-based CRC screening tests:
- Screening Guaiac-based Fecal Occult Blood Test (gFOBT) (CPT 82270)
- Screening Immunoassay-based Fecal Occult Blood Test (iFOBT) (HCPCS G0328)
- Cologuard™ – Multi-target Stool DNA (sDNA) Test (CPT 81528)
If the colonoscopy turns into a Diagnostic No do not use modifier KX: If you remove polyps during a screening colonoscopy
following a positive non-invasive stool-based test, report the appropriate CPT code (e.g., 45380, 45384, 45385, 45388) and add modifier PT (
colorectal cancer screening test; converted to diagnostic test or other procedure) to each CPT code for Medicare.
Was there a positive result from one of the tests? That is the only Time you would use the KX Modifier.
Hope this was helpful