Wiki PT modifier for anes during colonoscopy?

[sandraboty]

Highmark BS is telling us that for screening colonoscopies we should be adding a PT modifier to our charges. We bill them with the proper QX, QK QS, PS etc but as far as I know the PT modifier doesnt go on anes claims??
Has anyone ever billed this with the 00810 code?

Thanks,
Sandi Boty, CANPC

 

[mcnaryk]

Highmark BS is telling us that for screening colonoscopies we should be adding a PT modifier to our charges. We bill them with the proper QX, QK QS, PS etc but as far as I know the PT modifier doesnt go on anes claims??
Has anyone ever billed this with the 00810 code?

Thanks,
Sandi Boty, CANPC

Hi Sandi-

I have never used the PT modifier for anesthesia claims, only the modifers you listed above. In my experience though, BCBS considers anesthesia included in the colonoscopy service, and usually won't pay the seperate anesthesia claim. Good luck!!

 

[LisaAlonso23]

Per new legislation (Obamacare, 2015) we are to use 33 or PT modifiers to indicate a colonoscopy was a screening. Patients' screenings are to be covered 100%. The only way we, as anesthesia coders, can indicate screenings is by using diagnostic code V76.51 & appending 33 or PT modifiers to the CPT code.

For more information, check out the Anesthesia & Pain Coder's Pink Sheet, January 2015.