PFT's

[Shortcakecoder101]

Hi, I billed out 3 pft's and I received a denial stating a 26 modifer was needed. I've billed these before and never added a modifer. I'm wondering why the insurance company is stating this. Appreciate any help!!!

 

[cgaston]

Billing these with no modifier means you are billing for both the professional and technical components of these services (aka global). Unless your doctor owns the equipment, he/she can only bill for the professional component of the service which is signified with the -26 modifier.

 

[Shortcakecoder101]

Pft's

Ok now I understand, now how do you know when to use a TC modifer. One more question how can you bill for both technical/professional ? Under what circumstance would that occur?

Thanks!