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Modifiers for GA Medicare

  1. #1
    Default Modifiers for GA Medicare
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    Need some help please...

    GA Medicare is denying CPT codes 78226-26 and 78227-26 stating they need an additional modifier. Our office is billing these codes on behalf of the radiologist and billing for the professional component only. When we called GA Medicare, they directed us to their website where it listed all of the modifiers; however, we have not been able to find any modifier that is specific or required for these codes.


  2. #2
    I read that because of how the codes are listed in the CPT book with the semicolon, these codes cannot be used together. The 78227 includes the 78226. You can either use the 78226 without the pharmacologic intervention or jsut the 78227 for all the imaging including the intervention. This is not an add-on code. Let's see what other input we get on these codes.

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