Modifier PT
Colorectal cancer screening test converted to diagnostic/therapeutic — waives cost-sharing under ACA
✅ When to Use Modifier PT
When a screening colonoscopy identifies and removes a polyp. Replaces modifier 33. Patient should NOT be charged cost-sharing.
⛔ When NOT to Use Modifier PT
Only for colonoscopy screening-to-diagnostic conversion.
📋 Documentation Requirements
Op note showing polyp found during screening.
Modifier PT FAQ
What does modifier PT mean? +
Colorectal cancer screening test converted to diagnostic/therapeutic — waives cost-sharing under ACA
When should I use modifier PT? +
When a screening colonoscopy identifies and removes a polyp. Replaces modifier 33. Patient should NOT be charged cost-sharing.
When should I NOT use modifier PT? +
Only for colonoscopy screening-to-diagnostic conversion.
What documentation is required for modifier PT? +
Op note showing polyp found during screening.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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