Wiki Use of modifiers TC/26 on codes 95940/95941

[shofner14]

Can modifiers TC and 26 be appended to codes 95940/95941 when billing for intraoperative monitoring?
My practice only performs the professional component of the procedure. I think modifier 26
should not be used because the codes are time based and that the modifier should be used on
codes 95907- 95913.

 

[CodingKing]

95940 has PC/TC indicator of 0 - Physician Service Codes -- Identifies codes that describe physician services. Examples include visits, consultations, and surgical procedures. The concept of PC/TC does not apply since physician services cannot be split into professional and technical components.

95941 Has a PC/TC indicator of 9 -Not Applicable -- Concept of a professional/technical component does not apply.

95907-95913 have a PC/TC indicator of 1 which allows modifier TC or 26 - Diagnostic Tests for Radiology Services -- Identifies codes that describe diagnostic tests. Examples are pulmonary function tests or therapeutic radiology procedures, e.g., radiation therapy. These codes have both a professional and technical component. Modifiers 26 and TC can be used with these codes.

If you need to locate the PC/TC indicator, it's available on the Physician Fee Schedule lookup took on the CMS website. Select the option for all reimbursement info.