Otolaryngology Coding Alert

We'll Show You When to Code Function Test Components

Clip-and-save audiology reimbursement guide You can get paid for audiology services even when your practice doesn't perform all responsibilities, if you use modifier -26 or -TC.
 
These modifiers indicate that you are reporting the professional (-26) or technical component (-TC). When your otolaryngologist interprets the audiology test, you should claim the professional component. If he also owns the equipment and employs the audiologist, you should report the technical component. When the claim meets all three criteria - the physician interprets the report, owns the equipment and employs the audiologist - make sure to assign the global code, the unmodified test code.
 
Each component reimburses at a percentage of the global code. For instance, 92585 contains a total 2.70 relative value units. The professional component has 0.74 RVUs, and the technical side has 1.96 RVUs. Add the two sides together, and you get the total 2.70 RVUs that 92585 has.
 
Be careful: Before you report individual services, make sure the test contains these components. You may use modifier -26 or -TC for the following 10 audiology codes.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Otolaryngology Coding Alert

View All