Marina Posted Fri 05th of September, 2014 12:47:39 PM
We are an ophthalmology office that has a retina specialist come in once a month whom does his own billing. My question is, if the retina specialist performs a fluoroscein angiography and/or fundus photography on his patient using our equiptment are we able to bill for the technical component part of these procedures?
Marina Posted Tue 09th of September, 2014 16:48:41 PM
SuperCoder Answered Wed 10th of September, 2014 08:37:10 AM
Could you provide the codes/code range that you will be billing. With more specific code information I can provide the most accurate information regarding TC and 26 Modifier information for those codes.
See possible codes below:
92250-Fundus photography with interpretation and report
Example: For example, if an ophthalmologist doesnt have the equipment to perform fundus photography in the office, he or she sends the patient to the hospital, which takes the photographs. When the hospital sends the photos back, the physician interprets them, but because the ophthalmologist didnt perform the photography on equipment he or she owns the coder can bill for the professional component only: 92250-26. The hospital will bill for the technical component: 92250-TC. If you only perform the professional component and file 92250 with no modifier, you will be committing fraud because your claim will imply that you took the photos and interpreted them.
Marina Posted Wed 10th of September, 2014 19:00:40 PM
The retina specialist comes to our office, uses our equiptment and bills for codes 92235 and/or 92250. Can we bill the insurance company for the usage of our equipt. by the retina specialist? We do not do the interpreting.
SuperCoder Answered Mon 15th of September, 2014 10:46:31 AM
Thanks for your query!
You can bill for the equipment usage by billing by appending CPT/s with TC modifier and the retina specialist should bill by appending modifier 26 with the CPT/s they are assigning for their service.
I hope it answers your query.