Radiation CPT 77387

[bkemp15628]

Hi All

I was hoping for some help. CPT 77387 is now being denied by a few insurances because of the 26 or TC modifier. According to what I have searched these modifiers are allowed. What am I missing?
This code is usually billed with 77407 (effective 1/1/2026) in which neither of these modifiers are allowed. Is it because of 77407 being billed? There is no CCI edit though. These are not Medicare patient's so the 77407 would be correct.

 

[sls314]

Hi All

I was hoping for some help. CPT 77387 is now being denied by a few insurances because of the 26 or TC modifier. According to what I have searched these modifiers are allowed. What am I missing?
This code is usually billed with 77407 (effective 1/1/2026) in which neither of these modifiers are allowed. Is it because of 77407 being billed? There is no CCI edit though. These are not Medicare patient's so the 77407 would be correct.

You cannot bill the technical component of 77387. It is bundled with 77407: Radiation treatment delivery; Level 2, single-isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed

The professional component of 77387 is billable. Are you obtaining prior authorization for it? What is the denial reason being given for 77387-26?

 

[bkemp15628]

You cannot bill the technical component of 77387. It is bundled with 77407: Radiation treatment delivery; Level 2, single-isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed

The professional component of 77387 is billable. Are you obtaining prior authorization for it? What is the denial reason being given for 77387-26?

Thank you, I had misread the question being presented to me as we are billing with a TC modifier. We are not. We are billing with the 26 only. All procedures have been authorized for the patients. CPT 77387-26 has been denied with the explanation that professional and technical component split is not allowed for this procedure, I believe the denials are due to the fact that the technical portion now being bundled.

 

[alenu7@gmail.com]

We are getting denials for 77387 with & w/o modifier 26 from Medicare
denials w/ mod are stating "procedure code is inconsistent with the modifier used"
denials w/o mod are denying for invalid POS. - we are POS 22
sigh...

 

[tammy.kirkpatrick]

Hello all, I'm in Texas and billing POS 11 - I'm getting denials when billing 77407 & 77387 (no modifiers) from Humana. Denial - CO97 and Remark M80

 

[sls314]

Hello all, I'm in Texas and billing POS 11 - I'm getting denials when billing 77407 & 77387 (no modifiers) from Humana. Denial - CO97 and Remark M80 View attachment 9213 View attachment 9214

You need a 26 modifier for the 77387.

77407 includes the technical component of image guidance, even for POS 11.

(For my POS 11 facility, we bill the professional and the technical charges separately, but if you're submitting claims globally you need to distinguish that you're billing the 77387 for the professional component only.)

 

[tammy.kirkpatrick]

You need a 26 modifier for the 77387.

77407 includes the technical component of image guidance, even for POS 11.

(For my POS 11 facility, we bill the professional and the technical charges separately, but if you're submitting claims globally you need to distinguish that you're billing the 77387 for the professional component only.)

Thanks, it's just weird because we've been billing w/o the modifier for the past 6 months and they were paying and now all of sudden they're denying the claims. It's so frustrating because some insurance companies want the modifier and some don't.