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Wiki Medicaid requesting modifier for mammogram screeing

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koutler@gmail.com

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Hello,

Medicaid is now asking for a modifier for a mammogram screening. We use to bill procedure code G0202 for the screening but as of January 2018 the code changed to 77067. Being that the code is for a bilateral mammogram I didn't think it required a modifier. Would I need to use a TC modifier in this case?
 
Modifier

Per Optum Encoder Pro:

Procedure 77067 has both a technical and professional component. To report only the professional component, append modifier 26. To report only the technical component, append modifier TC. To report the complete procedure (i.e., both the professional and technical components), submit without a modifier.


Is it being billed with another similar code that would need you to indicate it was a different or separate procedure? If so, that may be the modifier they are looking at.
 
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