Modifier 26 is used when procedures have a professional and a technical component. CPT modifier 26 designates the service as â€śinterpretation onlyâ€ť and is most commonly submitted with diagnostic tests, including radiological procedures. You can refer to the Medicare Physician Fee Schedule database (MPFSDB) to determine if CPT modifier 26 is applicable to a particular procedure code.
Dr. X, staff radiologist, interprets a chest x-ray that was obtained in the hospital Radiology Department. Dr. X is contracted with the hospital to read radiographs. The equipment and staff are owned and/or employed by the hospital.
Dr. X should report the chest x-ray code with modifier 26, professional component. If he had performed the service with equipment he owned and staff that he employed, he could have reported the global, but since the hospital assumed the technical overhead, he can only report the professional component.
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