Wiki 26 and TC billed on same claim for labs

[bkemp15628]

Hi everyone,
I am hoping some one with lab knowledge can help. A fellow colleague ask me if a charge with the modifiers were correct. The coder billed 88342 / TC and 88342 / 26 on the same invoice/claim. The higher cost was denied, which is to be expected. I explained the difference in the modifiers and that I was not aware of any changes in that they could be billed on the same claim on separate lines. I even copied the AAPC information. The coder had come back with the explanation that it was billed correct per MCR MUE allowed units. No changes required.
My knowledge is more geared to the radiology portion so I could be very wrong. I have not kept up with the lab billing or the like.

 

[sls314]

Hi everyone,
I am hoping some one with lab knowledge can help. A fellow colleague ask me if a charge with the modifiers were correct. The coder billed 88342 / TC and 88342 / 26 on the same invoice/claim. The higher cost was denied, which is to be expected. I explained the difference in the modifiers and that I was not aware of any changes in that they could be billed on the same claim on separate lines. I even copied the AAPC information. The coder had come back with the explanation that it was billed correct per MCR MUE allowed units. No changes required.
My knowledge is more geared to the radiology portion so I could be very wrong. I have not kept up with the lab billing or the like.

If the services were billed on the same claim for the same provider, you'd bill the global 88342.

Technical (TC) and Professional (26) modifiers are used when the services are billed by separate providers. The modifiers indicate to the payer who was billing for which component of the service and that the claims aren't duplicates.

If it is all being billed on one claim for one provider, you don't need to separate the technical and professional components.

 

[bkemp15628]

If the services were billed on the same claim for the same provider, you'd bill the global 88342.

Technical (TC) and Professional (26) modifiers are used when the services are billed by separate providers. The modifiers indicate to the payer who was billing for which component of the service and that the claims aren't duplicates.

If it is all being billed on one claim for one provider, you don't need to separate the technical and professional components.

Thank you, I thought it was the same in all coding in this regard.