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Modifier 26 Question

  1. #1
    St. Louis, Missouri
    Default Modifier 26 Question
    Medical Coding Books
    My physician did a port placement under fluoroscopic guidance. He dictated his operative report and mentions in the body of his report that fluoroscopic guidence was used. He states that "the guidewire was advanced under fluoroscopic control. Fluoroscopy was used and the dilator and peel-away sheath were advanced." My physician wants to bill for the professional component of the fluorosopic guidence. My questions mentioning fluoroscopic guidence in the body of the operative report enough documentation or does he have to do a seperate report for the fluoroscopic guidence in order to bill for the professional component?

    Melissa Blow, CPC

  2. #2
    Springfield, Missouri
    Default modifier 26 Question
    My physicians documents how they used fluro w/ the port placments and I have not had any problems w/ the insurance not reimbursing for this. Yes, add your 26 modifier on the code if he is only do the professional portion.

  3. #3
    Vancouver Washington
    Thats a big debate in our office as well. Currently, as long as my doc documents the catheter position, and that the case was done under flouroscopic guidance, I code 77001-26. However, our compliance department is trying to come up with something definitative from CMS, as CPT has "hit and miss" instructions on the guidance codes about requirements.

    Good Luck!!

    Jaime Wicklund, CPC

  4. #4
    Lightbulb Mod -26
    Mod -26 is used when Dr is using it at a facility. If Dr owns the c-arm then no Mod -26.

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