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Modifiers -TC and -26...

  1. #1
    Question Modifiers -TC and -26...
    Exam Training Packages
    Hi Everyone!

    I have a provider trying to bill a 95810-26 and 95810-TC for one date of service, and then a 95805-26 and 95805-TC on the next day, based on the following rationale (although they did BOTH components):

    "Per coding review, the -TC needs to be billed for it is done in an off-site place and the physician isn't present. He interprets the testing in the clinic later, but the date of the testing is the DOS that is used for the interpretation. According to guidelines, this is the correct way to bill for these services."

    I have never heard this before! Is this correct??

    Thanks in advance!

    Jodie, CPC

  2. #2
    Location
    St. George Utah Chapter
    Posts
    40
    Question Modifiers -TC and -26
    Good afternoon,

    As anyone billed the modifiers -26 and -TC on the same line, when billing Medicare? It seems like a lot of extra fluff on your claim when you bill out the xray/ekg twice with the modifiers. Any suggestions?

    Thanks,

    Melissa

  3. #3
    Default
    You would want to bill global no modifers. You only us the TC for example if your doc provided the equipment and did the scan and the 26 modifer if your doc only provided the interpretation/report.

    Unless you doc owns the equiqment under a different practice name and tax ID and the intpretation is done under another tax ID you would bill global no modifiers.

  4. #4
    Location
    Columbia, MO
    Posts
    12,570
    Default
    In some regions if your practice is in a defined rural location, Medicare requires double line listing of radiology codes one line with a 26 and one line with a TC, as long as you own the equipment, and provide the interpretation. You should know from your Medicare FI if this applies to you.

  5. #5
    Location
    St. George Utah Chapter
    Posts
    40
    Default
    Thank you, we were waiting for an answer from Medicare (still waiting), you answered our question. Yes we are a rural location.

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