Results 1 to 4 of 4

modifers TC and 26

  1. Default modifers TC and 26
    Medical Coding Books
    I work for an insurance company and have a charge from same provider of service- billing a TC and 26 modifier for CPT codes- 95861;95920;95926;95928;95929.
    If I am correctly reading the CPT guidleine, these codes would include physician interpretation. The provider of servic is billing under 2 Tax ID#s- same place of service- and each billed amount is the same for TC and 26. When questioned if it is duplicate- were told ' No, billing for the technical and professional components. Is this correct ?

  2. Default
    Each of the codes listed (CPT codes- 95861;95920;95926;95928;95929) are eligible for the 26 and TC modifiers. However, if the provider billes the global fee utilizing the -00 modifier, then the professional and technical components are included in the global fee.

  3. Default
    So the physician "interpretation" and physician "component" mean 2 seperate concepts?

  4. #4
    The -TC and -26 represent the 2 components to the procedure: the facility's service of conducting the test, and the physician's service of reading and interpreting the results. In a perfect world, when the fees for both services are added together, they should result in the fee oaid for the global service.

Similar Threads

  1. Using Modifers 25 and 59
    By LucieV in forum Diagnosis Coding
    Replies: 1
    Last Post: 04-23-2013, 10:01 AM
  2. Difference between HO and HN modifers
    By crystalgriswold in forum Modifiers
    Replies: 2
    Last Post: 04-19-2012, 10:13 AM
  3. Modifers FA-T9
    By dballard2004 in forum Modifiers
    Replies: 0
    Last Post: 10-26-2010, 07:06 PM
  4. Modifers
    By bkp385 in forum Modifiers
    Replies: 6
    Last Post: 01-21-2009, 11:46 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.