About this policy
If during a colonoscopy a pathology is encountered that necessitates an intervention which converts the screening colonoscopy to a diagnostic/therapeutic colonoscopy, the appropriate CPT ® code which includes the –PT modifier for the diagnostic/therapeutic colonoscopy must be submitted with an appropriate diagnosis to justify the procedure such as Z80.0-Family history of malignant neoplasm of digestive organs. 1) Choose the correct CPT ® code which describes the procedure that was attempted. 2) Append the –PT modifier to the CPT ® code . The –PT modifier indicates a screening colonoscopy has been converted to a diagnostic test or other procedure. 3) Use an appropriate ICD-10 diagnosis code to indicate the procedure was a screening procedure. The diagnosis Z80.0- Family history of malignant neoplasm of digestive organs is an example of a diagnosis that can be used to indicate screening of beneficiaries at high risk.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.