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Modifier TC and 26 versus global charge

  1. Default Modifier TC and 26 versus global charge
    Medical Coding Books
    We recently had a cardiologist group join our group and begin using the same tax i.d. number. before we shared the tax i.d. we would bill the TC modifier and the cardiologist would bill the 26. Now that we are the same tax i.d. do we have to use the global charge or can we still bill with 26 and tc?

    Same with EKG do we have to bill the 93000 or can we continue to bill the the 93005 and 93010.

    We would like to keep it separate because we are separate groups operating under the same tax i.d.


  2. #2
    New Port Richey & Gulf to Bay
    I use to work for a very large multi-specialty physician clinic. We also had our own diagnostic imaging and laboratory department. When a primarcy care physician, or a specialist, ordered a radiological test, we would bill the global for the reading physician. That's from my experience.

  3. #3
    If you're billing for POS 11 I'd recommend you bill the global charge when submitting to the payers. If you demonstrate a trend of unbundling the charges for POS 11 you're going to raise some audit flags. I

    Logically speaking one unit (same TIN) billing for one service, should bill the global service when done in office.

    Hope this helps.

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