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In-office CT scan

  1. Default In-office CT scan
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    New client who owns CT scanner and performs studies in the office on patients. They are insisting that they can bill the code AND the code with the -26 modifier. Same physicians who own the scanner are reading the studies.

    Is there something very different with Radiology that I am missing? Doesn't the code (e.g. 70480) include both the provision of the test and the reading?

    If so, why would Medicare pay for both on the same date? e.g. pay for

    70480 AND 70480-26

    I appreciate your help - Thanks!

  2. Default CT Owned by practice
    Since the CT scanner is owned by the practice, wouldn't I just bill the 70480 with NO modifiers? Indicating both professional and techincal?

  3. #3
    Location
    Columbia, MO
    Posts
    12,568
    Default
    Yes you bill the procedure with no modifer to be reimbursed for the technical component, the ownership of the machine, and the professional component. In some rural areas Medicare will have you list it as 2 line items one with a TC and one with the 26, I have never figured out why

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Default
    Debra is absolutely correct... if it is owned and read by the same physician or business then no modifier is required.

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