A colorectal cancer screening test which led to a diagnostic procedure.

Correct Use

• When a service began as a colorectal cancer screening test and then was moved to diagnostic test due to findings during the screening
• Append the modifier to the diagnostic procedure code that is reported instead of the screening colonoscopy or screening sigmoidoscopy code
• Append to surgical procedure codes in the range: 10000-69999, G0500
• Append to the appropriately coded anesthesia procedure code associated to one of the above surgical codes

Incorrect Use

• Do not use the Modifier PT when the service began as a diagnostic procedure

Note: The Medicare policy waives the Part B deductible for all surgical procedures furnished on the same date and in the same encounter as a colonoscopy, flexible sigmoidoscopy, or barium enema that were initiated as colorectal cancer screening services and submitted with PT modifier.

Resources

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 18, Section 60.1.1