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modifier 26/tc

  1. Unhappy modifier 26/tc
    Medical Coding Books
    anybody can explain or help me how to bill 26 and TC in facility setting. our physicians renting an office in hospital, our physicians own the machine and does the reading and interpretation at the same time ex:92135 and 92136, we simply billed as 92135 and 92136, guess what we got denied by medicare as CO109- claim not cover by this payor... should we bill line item like 92135-26 on first line and 92135-TC on second line? thank you

  2. #2
    Location
    Columbia, MO
    Posts
    12,531
    Default
    Usually if you are in a designated rural setting then you need to double line bill with the TC on one and 26 on the other. Otherwise you bill with the global code.. What are you using for the place of service?

  3. Default
    Quote Originally Posted by amber97 View Post
    anybody can explain or help me how to bill 26 and TC in facility setting. our physicians renting an office in hospital, our physicians own the machine and does the reading and interpretation at the same time ex:92135 and 92136, we simply billed as 92135 and 92136, guess what we got denied by medicare as CO109- claim not cover by this payor... should we bill line item like 92135-26 on first line and 92135-TC on second line? thank you
    "claim not cover by this payor"

    I believe this means that Medicare is not the payor. The patient has other insurance coverage. CO-109 means you billed the wrong payor, check patient's eligibility.

  4. Default mod 26 and tc
    i forgot to mentioned that we got paid when we added mod 26 but we are trying to get reimburse on mod tc as well do you think we can add to the next line with mod TC.

    at Mitchellde we use place of service 22
    at Flatcoder we are aware of that but that was not the case because we got paid when we add mod 26 they just wont pay for global code, that's why i am asking what is the best way to code

  5. #5
    Location
    Columbia, MO
    Posts
    12,531
    Default
    Yes add the TC to a separate line entry you cannot put 26 and TC on the same line. Your POS is correct so then are you in a rural setting? If so then that is how you will need to bill all your radiology to Medicare.

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