Wiki Question Re: code 75658

phamil

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As a coding student, my class has come across an issue that has even confused the teacher. Just looking for a little more insight.

75658, Radiology Section
Angiography, brachial, retrograde, radiological supervision and interpretation

In one section of the text book, is reads that no modifier 26 is to be used if the CPT description includes the words "supervision and interpretation", however, on the next page it reads:

"If the radiologist is at the same facility as the equipment, you use code 75658 (angiography). If the radiologist is hospital-based, you use code 75658-26 on the CMS-1500 (hospital outpatient) and 75658 on the UB-92 (hospital inpatient)."

Based on the first explanation, you would never use a -26 with 75658, but then it reads that there are times when you would.

Which is correct, or can you explain when to use the -26 better than the book, we are all confused?

Thanks,

Penny Hamilton
 
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code 75658

Modifier 26 is used for physician interpretation.
Normally used when procedure is performed in a facility and not in the office.

Global charge 78658
Modifier 26 professional component 78658-26 (doctor would bill for this)
Modifier TC technical component 78658-TC (hospital would bill for this)

78658 without a modifier (global) means the procedure and equipment were performed by the doctor with his / her own equipment, in doctor office, with doctor staff.

I hope this helps.
;)
 
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