modifier pi

  1. R

    Wiki Can I bill PI modifier with a cancer diagnosis?

    I received a Medicare claim rejection for CPT code 78816-PIPO (PET/CT whole body) citing inconsistent modifier or required modifier is missing. The primary diagnosis listed on the claim is C61 (malignant neoplasm of prostate). I reviewed the CMS Billing and Coding policy which states, Claims for...
  2. K

    Wiki PI and PS modifier 78815/78816 subsequent at different facility

    Question when it comes to billing the same condition as a subsequent scan but for a different practice than the initial scan... do you still append the modifier PS since it's the same condition being followed up on, or does it change due to different facility? Does time ever play a factor? Say...
    • kathleeng
    • Thread
    • 78815 78815 and 78816 78816 modifier pi modifier pi and ps modifier ps pet scan pet scan modifiers pet scans subsequent pet scan
    • Replies: 0
    • Forum: Medical Coding General Discussion
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