CMS has expanded the range of service to which the PT modifier refers to include lower GI/endoscopy anesthesia CPT code 00810. Effective at the start of this year, CPT code 00810 used with screening colonoscopy services G0105 or G0121 will result in coinsurance and deductible being waived for anesthesia service when modifier 33 issued. If a screening colonoscopy becomes a diagnostic colonoscopy, providers should submit anesthesia code 00810 with the PT modifier. In this case, only the patient’s deductible will be waived, according to the report.
CMS advised providers to use the new X modifiers, a subset of modifier 59, until the agency instructs otherwise. The agency is still in the process developing protocols for the use of -X {EPSU} modifiers, according to the report.
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