• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Radiation CPT 77387

Create Wiki
B

bkemp15628

Contributor
Messages
13
Location
Illiopolis, IL
Best answers
0
Hi All

I was hoping for some help. CPT 77387 is now being denied by a few insurances because of the 26 or TC modifier. According to what I have searched these modifiers are allowed. What am I missing?
This code is usually billed with 77407 (effective 1/1/2026) in which neither of these modifiers are allowed. Is it because of 77407 being billed? There is no CCI edit though. These are not Medicare patient's so the 77407 would be correct.
 
bkemp15628 said:
Hi All

I was hoping for some help. CPT 77387 is now being denied by a few insurances because of the 26 or TC modifier. According to what I have searched these modifiers are allowed. What am I missing?
This code is usually billed with 77407 (effective 1/1/2026) in which neither of these modifiers are allowed. Is it because of 77407 being billed? There is no CCI edit though. These are not Medicare patient's so the 77407 would be correct.
Click to expand...


You cannot bill the technical component of 77387. It is bundled with 77407: Radiation treatment delivery; Level 2, single-isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed

The professional component of 77387 is billable. Are you obtaining prior authorization for it? What is the denial reason being given for 77387-26?
 
sls314 said:
You cannot bill the technical component of 77387. It is bundled with 77407: Radiation treatment delivery; Level 2, single-isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed

The professional component of 77387 is billable. Are you obtaining prior authorization for it? What is the denial reason being given for 77387-26?
Click to expand...
Thank you, I had misread the question being presented to me as we are billing with a TC modifier. We are not. We are billing with the 26 only. All procedures have been authorized for the patients. CPT 77387-26 has been denied with the explanation that professional and technical component split is not allowed for this procedure, I believe the denials are due to the fact that the technical portion now being bundled.
 
We are getting denials for 77387 with & w/o modifier 26 from Medicare
denials w/ mod are stating "procedure code is inconsistent with the modifier used"
denials w/o mod are denying for invalid POS. - we are POS 22
sigh...
 
You must log in or register to reply here.
Top