Wiki Radiology Coding

[MCornell87]

When coding for a ERCP for common bile duct stones with fluuroscopy time of 147.1 seconds on Medicare patient in a hospital setting...should you append Modifier -TC to cpt code? I do have included also HCPCS code G9500 with no modifier.

I have 43260-TC but am confused when to add modifiers -26 or -TC when hospital based?

Thank you!

 

[simam]

Lets say doctor charges 100 for services. You want to pay him full charges as he does every thing of certain proc.
However if same doctor does only interpretation you won't pay him full charges because he did only professional comp. So you will pay him 60 for his portion by attaching 26 which will reduce the price for him.

Most important factor is if doctor is the employee of hospital or not. And did he do complete services of that proc or not.
Hope it will help .

 

[CodingKing]

26/TC concept doesn't apply to CPT 43260. PC/TC indicator is 0 which means:

Physician Service Codes -- Identifies codes that describe physician services. Examples include visits, consultations, and surgical procedures. The concept of PC/TC does not apply since physician services cannot be split into professional and technical components. Modifiers 26 and TC cannot be used with these codes.