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Thread: Modifier 26

  1. #1
    Join Date
    Apr 2007
    St. Louis, Missouri

    Default Modifier 26

    AAPC: Back to School
    Scenario: A physician does a breast biopsy with ultrasound guidence at a surgery center. The radiologist performes the ultrasound during the procedure and the physician dictates in the operative report that the ultrasound was done and where it showed the mass was. My question is can the physician bill for the ultrasound with a 26 and if so does a seperate radiology report have to be dictated in order to bill with a 26?

    Melissa Blow, CPC

  2. #2

    Default 26 modifier

    Yes you can use a 26 modifier for the ultrasound billing. If the physician had used their own ultrasound machine, then there is no modifier needed.

    The physician I work for dictated a seperate radiology report when she used her own ultrasound machine. When she used the hospitals, the report was included in the biopsy report.

  3. #3
    Join Date
    Apr 2007
    Albany, New York



    If I'm understanding you correctly, a radiologist other than the physician doing the biopsy performed the ultrasonic guidance. Please verify.
    Karen Maloney, CPC
    Data Quality Specialist

  4. #4
    Join Date
    Apr 2007
    St. Louis, Missouri


    Yes, Karen that is what I mean. Does the physician have to dictate a seperate radiology report in order to bill for the ultrasound with a 26 or can it be included in the biopsy report?

    Melissa Blow, CPC

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