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Modifier 26 - ultrasound guidence

  1. #1
    Location
    St. Louis, Missouri
    Posts
    262
    Default Modifier 26 - ultrasound guidence
    Exam Training Packages
    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
    Location
    Albany, New York
    Posts
    456
    Default
    Melissa,

    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
    Location
    St. Louis, Missouri
    Posts
    262
    Default
    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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