modifier 26/tc

amber97

Guest
Messages
4
Best answers
0
anybody can explain or help me how to bill 26 and TC in facility setting. our physicians renting an office in hospital, our physicians own the machine and does the reading and interpretation at the same time ex:92135 and 92136, we simply billed as 92135 and 92136, guess what we got denied by medicare as CO109- claim not cover by this payor... should we bill line item like 92135-26 on first line and 92135-TC on second line? thank you
 

mitchellde

True Blue
Messages
13,426
Location
Columbia, MO
Best answers
1
Usually if you are in a designated rural setting then you need to double line bill with the TC on one and 26 on the other. Otherwise you bill with the global code.. What are you using for the place of service?
 
Messages
9
Best answers
0
anybody can explain or help me how to bill 26 and TC in facility setting. our physicians renting an office in hospital, our physicians own the machine and does the reading and interpretation at the same time ex:92135 and 92136, we simply billed as 92135 and 92136, guess what we got denied by medicare as CO109- claim not cover by this payor... should we bill line item like 92135-26 on first line and 92135-TC on second line? thank you
"claim not cover by this payor"

I believe this means that Medicare is not the payor. The patient has other insurance coverage. CO-109 means you billed the wrong payor, check patient's eligibility.
 

amber97

Guest
Messages
4
Best answers
0
mod 26 and tc

i forgot to mentioned that we got paid when we added mod 26 but we are trying to get reimburse on mod tc as well do you think we can add to the next line with mod TC.

at Mitchellde we use place of service 22
at Flatcoder we are aware of that but that was not the case because we got paid when we add mod 26 they just wont pay for global code, that's why i am asking what is the best way to code
 

mitchellde

True Blue
Messages
13,426
Location
Columbia, MO
Best answers
1
Yes add the TC to a separate line entry you cannot put 26 and TC on the same line. Your POS is correct so then are you in a rural setting? If so then that is how you will need to bill all your radiology to Medicare.
 
Top