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Modifier 26.. To use or not.

  1. #1
    Default Modifier 26.. To use or not.
    Medical Coding Books
    93314
    Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); image acquisition, interpretation and report only



    I'm confused on this code, in Encoder this CPT 93314 show a professinal and technical component. But the description reads interpretation and report only.

    If your physician is providing the service CPT 93314. Are you using modifier 26 on this.

    I'm getting a denial from Medi-caid that you can't use modifier 26 on this code.


    Thanks
    Daniel,CPC

  2. Default
    Quote Originally Posted by daniel View Post
    93314
    Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); image acquisition, interpretation and report only



    I'm confused on this code, in Encoder this CPT 93314 show a professinal and technical component. But the description reads interpretation and report only.

    If your physician is providing the service CPT 93314. Are you using modifier 26 on this.

    I'm getting a denial from Medi-caid that you can't use modifier 26 on this code.


    Thanks
    Daniel,CPC

    Daniel,
    go to this page and scroll down about half way. Read what it says about the 93314 not using modifier 26.

    http://www.sccm.org/Publications/Cri...andCoding.aspx
    Theresa CCS-P CPMA CCC ICDCT-CM

  3. Default
    I use the medicare fee schedule on our Medicare provider's website (Trailblazers). It allows me to search by CPT Code. Under the indicators section of the fee schedule, it will tell you if there is a profession/technical component. For your code 93314, modifer 26 is allowed. See attached website to see what I'm viewing:
    http://www.trailblazerhealth.com/Too...eSchedule.aspx

    Vanessa, CPC

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