WebModifier -33 is used for commercial insurance claims. For example, if a physician performing a screening colonoscopy on a patient with commercial insurance finds and removes a polyp with a snare, use CPT code 45385 and append modifier 33 to the CPT code. If the patient is a Medicare beneficiary, use CPT code 45385 with modifier PT. WebNationwide, >95% of all Cologuard patients have no out-of-pocket costs for screening. Exact Sciences estimate based on historical patient billing as of June 30, 2024. Rate of coverage varies by state and region. Exceptions for coverage may apply; only your patients' insurers can confirm how Cologuard would be covered. 1. Reference: 1. Data on file.

Coding FAQ - American Gastroenterological Association

WebPatient Billing for Cologuard. We highly encourage patients who receive a bill with out-of-pocket responsibilities after using Cologuard to call 1-844-870-8870 and speak with a member of our Patient Support Team to discuss appeal support. More information on Cologuard insurance coverage, billing FAQs, and patient appeal tools can be found at ... first service status certificate

Screening for Colon Cancer: Know Your Options Aetna

WebA screening can help find cancer even if you have no symptoms. And a colonoscopy isn’t the only test available. There are some you can do at home. Even if you have no family … WebEffective January 1, 2016, use CPT code 81528 when billing for the Cologuard™ test (note that your MAC will accept HCPCS code G0464 for claims with dates of service on or … WebMar 1, 2024 · Procedure performed: Screening colonoscopy. Coding: G0105, Z80.0 for Medicare patients (no cost-sharing) 45378-33, Z80.0 for Medicaid and commercial patients. Rationale: For Medicaid and commercial patients, append modifier 33 to the CPT® code to eliminate patient cost-sharing (copay, coinsurance, and deductible). camouflage sweaters for women