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91010-26

Tammy Posted Fri 07th of February, 2014 12:14:15 PM

When can we bill for the Professional component?
When we do the test or read it?
Thank you!!

SuperCoder Answered Mon 10th of February, 2014 16:21:27 PM

A gastroenterologist can bill for the technical component when he or she owns (or partially owns by being a partner in a practice) the equipment being used. In your case, you can report both the technical and professional components when the physician interprets the results of a patients manometry test by using global code 91010 (esophageal intubation and collection of washings for cytology, including preparation of specimens [separate procedure]) without any modifiers.
The professional component represents the physician's interpretation of the test results. When the gastroenterologist only interprets the manometry results, as your doctors used to do, he or she may bill for the professional component by attaching modifier –26 (professional component) to 91010.
The technical component represents the value assigned to the ownership and maintenance of the equipment and the use of any technicians. If the manometry is done in a hospital, then the hospital bills for the technical component by attaching modifier –TC (technical component) to the manometry code.

Tammy Posted Wed 12th of February, 2014 15:10:01 PM

Thank you. We are billing for a the physican side the TC was done at the hospital and we can not bill for it. However the provider does read the results. What DOS do we add to our bill the day he reads it or the day it was done at hospital?
THanks again.

SuperCoder Answered Fri 14th of February, 2014 05:17:46 AM

“The appropriate DOS for the professional component is the actual calendar date that the interpretation was performed. For example, if the test or technical component was performed on April 30th and the interpretation was read on May 2nd, the actual calendar date or DOS for the performance of the test is April 30th and the actual calendar date or DOS for the interpretation or read of the test is May 2nd.”

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