Nancy Posted Wed 05th of January, 2011 18:07:26 PM
What can anyone tell me about the new Medicare Modifier when billing for the ASC? And, also do the Medicare replacement policies use it? Thanks
SuperCoder Answered Wed 05th of January, 2011 22:17:43 PM
A new HCPCS modifier takes effect Jan. 1, 2011, for use in cases where a screening colonoscopy or screening flexible sigmoidoscopy was planned, but clinical findings leads to a diagnostic colonoscopy, according to the Ambulatory Surgery Foundation.
Modifier –PT will "prompt the claims processing system to waive the deductible for ALL surgical services on the same date of service as the diagnostic service," according to the ASF. "Unlike the additional waiver of copayments and coinsurance for straight screening services allowed by the Patient Protection and Accountable Care Act, if the planned screening service becomes a diagnostic service, only the deductible is waived."
Will soon update you about Medicare policy on this.
Krissie Answered Fri 11th of March, 2011 15:36:25 PM
On this same topic, can anyone help me with the place of service coding for an Endoscopy Suite? Do we bill the Place of Service 24 or 11? And we bill the facility fees and the physician's professional fees. Do we indicate TC modifier for all the facility fees and 26 modifier for the professional?
Thanks for any feedback you can give!