Wiki Pulmonary Test Coding - Repeatedly, in 2012

[fredcpc]

Repeatedly, in 2012, Medicare has been denying several of the Respiratory test CPT codes. They usually dont like my modifier choice, but I have tried just about every combination. So, can someone help with this?

According to Medicare guidelines for 2012, how do you code (w/modifiers), CPT 94060 and 94726?

 

[ewinnacott]

Do you want to know about billing with the -TC and -26 Mods or an unbundling mod like -59?? These codes do not bundle so a -59 is not needed. As far as -TC and -26 it all depends on what the doctor is doing. Is he performing the test then sending out to another doctor like a cardiologist for the read or to give the results to the patient? In that case you would use the -TC and if the opposite is happening then I would use the -26. If the doctor is doing both then I would not attach any modifiers.