Wiki Modifier 33

KoBee

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When screening converts to diagnostic/therapeutic and different techniques were done on multiple polyps in different locations of colon. Does the modifier 33 go on both CPT?

Example:

polyp in descending colon removed by cold snare = 45385
polyp in sigmoid colon removed by excisional biopsy with cold forceps = 45380

Coding:
45385 - 33
45380 - 59

or

45385 - 33
45380 - 33,59 or 59,33
 
Don't know if you got your answer on this - but we use it on both procedure codes - due a system edit that is in place in our system and have not had problems doing so, but I think just using it once is supposed to be correct as well. The modifier that impacts payment is reported first, in this case the 59. Then the 33.
 
I would put the 33 on the first code only with the highest RVU and then the 59 on the second code.
 
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