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Thread: Modifiers TC and 26

  1. #1

    Default Modifiers TC and 26

    AAPC: Back to School
    I understand the difference between these modifiers, but I have a question regarding the correct use.

    We only perform the x-ray at my clinics. We send the x-rays out to be read by an outside radiologist. We have a contract with the radiologist for the reading of the films and we pay him/her for this service. My question is do we still appended modifier TC to our x-rays since we pay the radiologist for the read? I don't know if the radiologist bills or not. Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2
    Join Date
    Apr 2007
    Evansville Indiana

    Default Modifier TC and 26

    If you have a contract and are paying the radiologist to read the x-rays, then you should be billing globally and they should not be billing. If he is billing then you shouldn't be paying him for a service that he is already being paid for by the insurer.

  3. #3


    Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  4. #4
    Join Date
    Apr 2007
    North Carolina



    I completely agree with Cheermom. I've experienced similar arrangements and this is exactly how we handled the billing.

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