Wiki CPT 78492 denied - To require modifier from BCBS Florida

[01289355]

We called to BCBS insurance and provided the below comments,

CPT 78492 is a Cardio imaging procedure and for its need more appropriate modifier should be obtained to indicate the clinical determination. suggested to send corrected claim with valid modifier for the CPT 78492.

DOS 02/11/2019.

We have billed only PET service for this DOS and no additional service billed on same day. Also patient does not have any global.

Can you anyone suggest what modifier require for this.

 

[cgaston]

I believe you need a -26 modifier to signify that you are billing for the professional component only.

 

[01289355]

This service performed in office (POS-11), so professional component included