Wiki 77085

[coding4fun]

We are NOT hospital based, we own our own DEXA equipment. When billing for a DEXA (77085), I bill only the one code. The DEXA scans are being done in our office

How do I bill for the interpretation of the DEXA scan. One particular physican likes to read the DEXA scans and he is now requesting that we bill for the interpretation.

Please advise how I would capture the billing for this scenerio.

Thanks,

 

[mhstrauss]

We are NOT hospital based, we own our own DEXA equipment. When billing for a DEXA (77085), I bill only the one code. The DEXA scans are being done in our office

How do I bill for the interpretation of the DEXA scan. One particular physican likes to read the DEXA scans and he is now requesting that we bill for the interpretation.

Please advise how I would capture the billing for this scenerio.

Thanks,

Have you been billing with the TC modifier? If not, then you are already billing for the interp. Per the RVU files, 77085 is a global code...so if no modifiers are being used, you should be getting global reimbursement. If you are using the TC modifier, just leave it off.

 

[coding4fun]

We are currently billing only the 77085 (no modifiers)

I feel that we should be billing
77085-26 & 77085-TC

We own the equipment, NOT hospital based. If the 26 & TC modifiers are correct, can they be billed to all carriers?

thanks for any and all help with understanding this process

 

[mhstrauss]

We are currently billing only the 77085 (no modifiers)

I feel that we should be billing
77085-26 & 77085-TC

We own the equipment, NOT hospital based. If the 26 & TC modifiers are correct, can they be billed to all carriers?

thanks for any and all help with understanding this process

If your clinic owns the equipment, and the physician that is performing the interp is employed by the same clinic, then just bill the 77085 without any modifiers. There is no reason to separate out the components if both are being billed by the same entity.