Wiki Modifier -26

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Pgomez76

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Hello,

I am currently studying Medical Coding and I have a question regarding -26.

I asked if all the radiology reports should include the modifier -26. (Please see bottom response and tell me if you agree. :)

We can't use modifier 26 because it doesn't state “interpretation and report” only in the case scenario. We have to assume that the x-ray, and interpretation and report were done in the facility.

Thanks
 
All reports will not include a modifier 26. It depends. Modifier 26 is used for interpretation and report of the x-ray films. Some offices own their own x-ray machines and they read the results. In this case the whole component of the x-ray is billed with no modifier. If an office owns the machine and performs the x-ray but doesn't not read the results - they send them to a radiologist - the office can bill the TC modifier and the radiologist would bill the 26 modifier. You should not assume but you should find out prior to coding for any facility that deal with x-rays what their arrangements are for reading the x-rays to bill correctly. Hope this helps and good luck!

Shannette Avara, CPC
Coding Manager - UCA
 
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