Wiki CPT 88112 and modifier 26 for professional service only

[marybrady1]

Hello all! For the professional component for 88112, is modifier 26 required? This is a cytopathology code and I'm not clear if modifier 26 is required or if this should be billed globally as 88141 is billed. I've been coding with the modifier 26 but am unclear if that's correct. Any thoughts would be greatly appreciated!!

 

[CodingKing]

88141 has a PC/TC indicator of 2 - Professional Component Only Code so 26/TC concept does not apply and its always considered professional

88112 has PC/TC indicator of 1 which means 26 or TC is needed if the full global component is not performed by your provider.

The PC/TC indicator can be found by reviewing the Medicare Physician Fee Schedule Payment Policy Indicators. Also if you were to look at 88112 on the fee schedule there will be a break out for Global vs TC vs 26 rate.

 

[marybrady1]

Hey thanks!