Wiki Tc & 26?

[Tracey Thompson]

How would you bill both intraoperative monitoring technical fee and professional read fee for the following situation.....

95920- Intraoperative Neurophysiology Monitoring- Billable Hours 1.00
95938- Upper and Lower Extremities SSEP
95861- Upper EMG, Units 2
95939- Upper and Lower Extremities TCeMEP
95937- Neuromuscular Junction Test (TO4)
95955- EEG Non-intracranial Surgery

If you need more information in order to answer my question, please let me know.

Thanks!

 

[cblack712]

I am not 100% sure what you are asking and without seeing the reports I can not give you an answer with 100% accuracy. However, I can tell you this -- two seperate entities have to be involved in order to bill with the tc/26 mods -- IE --- the reading Physican (26 mod) may have a contract with the entity providing the service (tc) but is not employed by them. If it isn't the reading Physicians equipment - or equipment belonging to his/her group then you can split the charges with the tc/26 mod. Each of those CPT codes listed above have an RVU for the split indicating you can bill the CPT 2x ie - 95920-26 and 95920-TC.
You can look it up at this site:
http://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx
once you put the cpt code in you will see a price for the tc, a price for the 26 and a price without a modifier. If there is not a price in one of those fields than you can not use a tc/26 on the code.
Hope that helps some!

 

[mjb5019]

Tc 26

Whomever owns the equipment usually gets to bill the TC portion.