# PT Modifier - CMS



## sbarrila (Dec 20, 2010)

Does anyone have any information on the use of the PT modifier for screening procedures (GI) as of 1/1/11.  I am unable to locate anything on CMS and a lot of our commercial payers & Medicare managed care plans know nothing about this modifier.  Any help is appreciated.  Thanks,


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## cbarry (Dec 20, 2010)

The PT modifier information is located in the MLN Matters number MM7012 release date 07/30/10.  Not sure if that helps or not.  The good thing is that if the patient comes in for a screening colon and then becomes diagnostic, append the PT modifier and the deductible and the co-ins are still waived as if it were a screening.


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## sbarrila (Dec 21, 2010)

from what i understand it is only the deductible that is waived, not the coinsurance


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## mitchellde (Dec 21, 2010)

That is correct it is the deductible that is waived.


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## andavis234 (Nov 3, 2021)

cbarry said:


> The PT modifier information is located in the MLN Matters number MM7012 release date 07/30/10.  Not sure if that helps or not.  The good thing is that if the patient comes in for a screening colon and then becomes diagnostic, append the PT modifier and the deductible and the co-ins are still waived as if it were a screening.


we have a denial for 45385 and the insurance company (NOT Medicare) is requesting PT modifier to be added- is there a different modifier other than PT for this circumstance? thank you in advance.


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