Wiki Modifier 26 Question

[mmelcam]

My physician did a port placement under fluoroscopic guidance. He dictated his operative report and mentions in the body of his report that fluoroscopic guidence was used. He states that "the guidewire was advanced under fluoroscopic control. Fluoroscopy was used and the dilator and peel-away sheath were advanced." My physician wants to bill for the professional component of the fluorosopic guidence. My questions is......is mentioning fluoroscopic guidence in the body of the operative report enough documentation or does he have to do a seperate report for the fluoroscopic guidence in order to bill for the professional component?

 

[mstallings]

modifier 26 Question

My physicians documents how they used fluro w/ the port placments and I have not had any problems w/ the insurance not reimbursing for this. Yes, add your 26 modifier on the code if he is only do the professional portion.

 

[jaimewicklund]

Thats a big debate in our office as well. Currently, as long as my doc documents the catheter position, and that the case was done under flouroscopic guidance, I code 77001-26. However, our compliance department is trying to come up with something definitative from CMS, as CPT has "hit and miss" instructions on the guidance codes about requirements.

Good Luck!!

Jaime

 

[SANDYB42012]

Mod -26

Mod -26 is used when Dr is using it at a facility. If Dr owns the c-arm then no Mod -26.