Wiki modifier 51 - doing urodynamics

[dmkubida]

We are an OB/GYN practice doing urodynamics in the office. Typically- we bill global and add 51 modifier to appropriate codes. We are then billed by the supplier and we pay them for coming in and performing the tests.

They are telling us if we bill out the codes with TC modifier on day of service; then- when the patient returns and the dr interprets, bill codes with 26 modifier: We would receive greater reimbursement as we should not use the 51 mod on the TC side?????

Does this sound correct to anyone?????

 

[akonyk]

Modifier 26? TC? 51?

It was my underrstanding that if you own the machine (urodynamics) that you would bill globally and not separate out the technical and professional component.
If you rent the machine or pay someone to come in and do the test you would be billing it globally as well. it may be considered double dipping for billing the professional wen the pt comes back to review tests.

 

[brendalewing]

TC and 26 split the global fee... it pays exactly the same... use tc if you own the equipment, use 26 for professional component only, if the MD does not own the machine but reads the results.

So, if you own or rent or lease the machine, and your physician reads results, do not split, bill global.