Results 1 to 6 of 6

Billing Modifiers 26/TC.

  1. #1
    Default Billing Modifiers 26/TC.
    Exam Training Packages
    I work for a small family practice and we are having difficulty understanding if our providers should be appending modifiers 26 or TC to diagnostic studies that are done in the office. For example the doctor orders an echocardiogram to be done on a patient and we have a person who comes in to perform the test. The interpretation of the results is done by another provider outside our office. After the results are confirmed they are then faxed over to our office and the patient comes in for a follow up on the results to be read by our provider. If our provider didn't do the interpretation of the test and didn't perform the test, but it was only done in our office would he bill the diagnostic study with either modifier 26 or TC?

    Thanks,

    Raquel

  2. #2
    Location
    Columbia, MO
    Posts
    12,570
    Default
    You would not use the 26 as that is for the provider that provided the interpretation, going over the results with the patient is part of the E&M, you would use the TC only if you own the equipment, if you simply provide the office space for a company to have their tech and equipment perform this test then they will bill the TC. Meaning there is nothing for you to bill outside of the E&M.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default Billing Modifier 26/TC.
    So what is our doctor suppose to bill if he is the one who ordered the test to be done? The provider who interprets the results for our provider does not bill anything nor does the tech who comes in to perform the study, so what if the doctor is in the office while the study is being performed then can he bill for it?

    Thanks

  4. #4
    Location
    Baton Rouge
    Posts
    1,239
    Default
    If the doctor who is interpreting the tests isn't billing anything, he is definitely losing money. Does your office pay him under contract? If that's the case, then your office can bill global if you also own the equipment. If you don't own the equipment, then your office can bill with the 26 modifier.
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  5. #5
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by chavera View Post
    So what is our doctor suppose to bill if he is the one who ordered the test to be done? The provider who interprets the results for our provider does not bill anything nor does the tech who comes in to perform the study, so what if the doctor is in the office while the study is being performed then can he bill for it?

    Thanks
    So it would appear from your post that your office pays the tech and interpreting physician for their services. Then you bill the global test code.

    I would clarify that this is the case before proceeding, in case the other providers are billing for their services.

  6. Default
    A provider can not code a test by order only. It has to be performed in a premises and on a patient. who performs that test can only bill the services, may be interpretation or technical.

    Thanks
    Rajesh Verma

Similar Threads

  1. Need help with Modifiers and Billing!
    By brachi91@gmail.com in forum Modifiers
    Replies: 1
    Last Post: 12-01-2013, 07:36 PM
  2. billing and modifiers
    By boozaarn in forum Billing/Reimbursement
    Replies: 0
    Last Post: 04-09-2011, 06:42 AM
  3. Billing with unnecessary modifiers
    By gibskk1 in forum Medicare Regulations
    Replies: 6
    Last Post: 11-23-2009, 10:26 AM
  4. ASC Billing modifiers
    By kdornes in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 11-27-2008, 01:26 PM
  5. Pathology Billing Modifiers
    By LIA2600 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 06-16-2008, 06:00 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.