Wiki EEG question

[debrakae]

I have my Neurology doctors doing rounds at the hospital and performing EEGs (95953 and 95819) for some of the patients. I am getting denials from Medicare that these are Part A codes and need a modifer. Does anybody know what modifier I would need to add?

Thanks.

 

[aaron.lucas]

Since Medicare Part A is hospital only, I would be inclined to say modifier -26, showing that it's a physician providing professional services. The docs aren't supplying the equipment right, they're just using the hospital's machines to run the tests? Anybody else have any thoughts?

 

[mhstrauss]

I agree with modifier 26; we do a lot of these. Since the physician doesn't have the cost of the equipment while interpreting at the facility (per the RVU file there are both professional and technical components) 26 is needed.

 

[debrakae]

Thank you both very much.