Can someone clarify for me about the PT modifier. I was told that the diagnosis code 211.3 should not be used with the PT instead it would have to be an 835.xx code. Is this correct?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki PT modifier
- Thread starter dlandrus
- Start date
coachlang3
True Blue
That is partially incorrect.
PT is Medicare's modifier to show a colon cancer screening has turned diagnostic.
IE:
If you would have coded:
G0121 and V76.51 if nothing had been found.
But coded:
45385, V76.51,211.3 because a poylp was found. Then you would add the PT modifier.
It is only for use with a colon cancer screening turned diagnostic. It has more to do with the CPT code chosen than the ICD 9 chosen but it still is part of both.
PT is Medicare's modifier to show a colon cancer screening has turned diagnostic.
IE:
If you would have coded:
G0121 and V76.51 if nothing had been found.
But coded:
45385, V76.51,211.3 because a poylp was found. Then you would add the PT modifier.
It is only for use with a colon cancer screening turned diagnostic. It has more to do with the CPT code chosen than the ICD 9 chosen but it still is part of both.
mitchellde
True Blue
I am not sure who you spoke with but the 2 dx codes you have quoted are as different as night and day.
for the 211.3, benign neoplasm of the colon:
The PT modifier is for Medicare to indicate a colonoscopy that was a preventive screening but contains a diagnostic component due to abnormal findings. Because we cannot code the screening procedure code with the polypectomy procedure code. we bill the polypectomy code and attach the PT modifier which then prevents the patient from being billed for a surgical deductible.
the other code you quoted was for a 835.xx dislocation of a hip and at no time would be associated with a PT modifier.