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Modifier 26

  1. #1
    Default Modifier 26
    Medical Coding Books
    Would you ever append a modifier 26 to CPT 58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and /or polypectomy, with or without D & C?

    Provider saw the pt in their clinic for the office consult but is performing the surgery in another facility. The facility will be billing for the supplies and facility use and the provider will be billing for the services??

    I am very new to the coding field and I thought modifier 26 was just for radiology or pathology but was was asked this type of question and now am second guessing??

    Thank you

  2. #2
    Terre Haute
    mod 26 is used for the physician side and mod TC is used for the facility side. with this being said, the WPS fee schedule does not list 58558 with a "26" "TC" and global. there for it is only 1 fee and no modifier is needed. hope this helps :-)
    LeAnn Floyd-CPC
    Senior IP/OP coder
    Conifer Health
    2016 Member developement Officer Terre Haute IN Chapter
    2015 President Terre Haute IN Chapter

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