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-TC -26 urodynamics

  1. #1
    Question -TC -26 urodynamics
    Medical Coding Books
    My physician owns the machine used in these procedures. If he is performing the testing in one visit and then interpreting the test done on the next visit(different day), should we be billing this as:

    first visit: 51729-TC
    next visit: 51729-26

    Not like this?
    first visit: 51729
    next visit: 99213

    In HCPCS II book, the explaination for -TC says Technical component charges are institutional charges and not billed seperately by physicians...

    But if he owns the machine this is allowed?

    Thank you for your help!

  2. #2
    If your doctor owns the machine and is the doing the interpreting, you bill the code(s) once on the day the service was actually done, but without the modifiers. You should not bill the TC one day and the 26 the next.

    Zaida, CPC

  3. #3
    I do not split it up even though the test was done and no interpretations are done until the next visit? Sorry I just want to make sure before we change anything. When looking at the medicare fee schedule it will be reimbursed at the same amount but I just want to make sure we are not billing incorrectly. We have been doing the billing as you suggested but the doctor questioned this due to an article from the AUA...
    Last edited by Melissa-ASL-PMB-07; 05-27-2011 at 01:58 PM.

  4. #4
    We're having this issue where I work as well. The docs are usually not doing the interpretation until the next day. From what I understand, the majority of the commercial carriers don't care (meaning you can bill it w/o any modifiers all at once even if the interpretation was done a day later) they are willing to give some latitude about that. But, again from what I understand, the government payers is where the problem is coming up. If you're billing for the whole 'kit and caboodle,' they wanna know that the interpretation was done on the date of service that you billed. Unfortunately, our company hasn't quite resolved that issue yet, we're still working that out. Sorry, I couldn't help, just wanted you to know that you're not alone.

  5. #5
    Thanks Kandigrl79, I appreciate the input! I'm glad I'm not the only one!
    Melissa, CPC

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