AAPC - Back to school
Results 1 to 2 of 2

Thread: X-ray With Modifier 26, Or E/m

  1. #1
    Join Date
    Apr 2007

    Default X-ray With Modifier 26, Or E/m

    AAPC: Back to School
    Say You Have Two Different Practice Next To One Another. Not The The Same Grp. Both Family Practices.

    Patient Comes In. Sprain Ankle Is Diagnosis And The Physician Does The Whole Work Up And Documents The E/m Service. The Physician Then Sends The Patient Next Door To Get The X-ray Done On The Ankle. We Bill For The E/m Service For This Visit.


    Couple Days Later The Patient Comes Into The Original Practice They Were Seen, And The Physician Interprets The X-ray And Then Sends Them To Are Ortho Specialist.

    I Bill An E/m For This Service Right. That's My Understanding. But One Of My Collecters Here Says He Has Experience With Billing Out A X-ray With Modifier 26 For This Service. He's Basing This On His Experience Dealing With Er Billing. He Says The Er Doctors Would Bill Out For The X-ray Interpretation With Modifer 26 And An E/m Er Service And The Radiologist Would Also Bill Out The Same Way, Xray And Mod 26.

    My Understanding Is The Modifier 26 Is For The Radiologist Interpretation. And The Interpretation Of The X-ray For A Family Physician Is Counted Towards The Medical Decision Making In The E/m Guidelines.

    Daneil, Cpc

  2. #2
    Join Date
    Apr 2007


    Does your physician's office not have have x-ray equipment to perform radiological services? If not, then the office that is performing the x-ray can only code the 70000 series code with a -TC component, only. An E&M is not medically necessary for that type of visit. The provider that orders the test can code the 70000 series with modifier -26 for the professional componet and an E&M level for the acute visit.

Similar Threads

  1. Modifier 22 on x-ray
    By 08pancho in forum Emergency Department
    Replies: 5
    Last Post: 03-06-2015, 10:41 AM
  2. 25 modifier with e/m and x-ray
    By NFBarner in forum Orthopaedics
    Replies: 7
    Last Post: 05-16-2014, 12:21 PM
  3. X-ray before and after
    By jenkins62 in forum Orthopaedics
    Replies: 2
    Last Post: 02-17-2011, 11:52 AM
  4. X-ray With Modifier 26
    By daniel in forum Interventional Radiology
    Replies: 5
    Last Post: 11-06-2008, 04:50 PM
  5. X-ray With Modifier 26, Or E/m
    By daniel in forum E/M
    Replies: 3
    Last Post: 11-05-2008, 12:34 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?


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.