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93970

  1. #1
    Question 93970
    Exam Training Packages
    I AM NEW TO CODING FOR RADIOLOGY AND THE CHARGES I POST ARE FOR HOSPITAL INPATIENT. MY QUESTION IS...YES OR NO DO I USE MODIFER 26 WITH THIS CPT CODE? THANKS!

  2. #2
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    No - not if you're billing facility/technical component - No
    26 is a professional component
    Donna, CPC, CPC-H

  3. #3
    Question
    Ah, but I am doing the professional component. Our Rads read for the hospital inpatients. So I would use modifer -26 then? The equipment is the hosp. The rads our mine. Gah! So confusing! I will learn this stuff though!

  4. #4
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    so who bills the TC portion?
    I had it easy when I coded radiology for our hospital - we had to code both sides so there was always a TC/26 (unless of course the code was specific to be pro/tech only)
    Donna, CPC, CPC-H

  5. #5
    Default
    The hospital bills for the TC I believe. We are a separate organization altogether.

  6. #6
    Location
    Milwaukee WI
    Posts
    4,466
    Default Yes use -26 for professional component only
    Well, JDenniston, we all learned a good lesson from this thread - be clear when you post your question.

    I too, thought you were coding for the hospital from your first post, but now that I re-read it I can interpret it as being the radiologist who is reading the films.

    Okay .. your radiologist is a separate entity, separate tax ID from the facility which owns the equipment. You would bill the radiology codes with -26 modifier.

    Have a good weekend!
    F Tessa Bartels, CPC

  7. Default
    I work Medicare denials and know that Medicare requires a 26 modifier on professional charges for this CPT if done in ER or INPT. Office POS does not require a 26 modifier.

  8. Smile Sandy Mitchell CPC, RCC
    Hi,

    I too am a radiology coder, whose doctors are hospital based. I have 10 years radiology coding experience, anytime you have a question, please fill free to contact me directly at my email address sandra.mitchell@rahmail.net

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