• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki 26 modifier on a surgery code??

Create Wiki
A

avrilw

Networker
Messages
27
Location
Newport, WA
Best answers
0
Our facility bills out a claim for the facility fee on our surgeries and then we bill a separate professional claim for the physician fees. Our facility coder is telling us we need to bill a 26 modifier on our professional claim for procedure 44970 (Laparoscopic Appendectomy). Is this correct? I have never billed 26 modifiers on surgical codes before. Can someone please provide some insight? Thank you!
 
That is not correct - surgical procedures do not have technical and professional components. If you look up any code on the CMS website under the physician fee schedule, it will tell you the PC/TC indicator, which designates whether or not the code includes these components. CPT 44970 does not have a professional component and billing that code with modifier 26 would be an error.
 
You must log in or register to reply here.
Top