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Thread: Modifier 26

  1. #1

    Smile Modifier 26

    AAPC: Back to School
    Patient bring their own x-rays to there visit. Doctor needs to read them, can we bill the 26 modifier with x-ray code and be paid?

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Probably not

    The X-rays have probably already been read and interpreted (with appropriate report) by a radiologist. What you will do is give the physician additional data points for personally reviewing the X-rays ... this goes towards medical decision making.

    If ... Big Red IF ... your physician IS going to be actually interpreting and writing a report, then you would code with the -26 modifier (profesional component) ... BUT you would NOT give him the extra credit on the E/M MDM data points (he's already getting compensated by billing for it).

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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