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Cynthia Posted Tue 21st of November, 2017 15:33:29 PM
if the physician takes an x-ray and reads the results would the procedure code need the modifier 26. Is the payment higher for the interpretation and the x-ray?
SuperCoder Answered Wed 22nd of November, 2017 06:06:37 AM

>Modifier -26 identifies the physician's or professional component of a two-component (professional and technical) service. >The physician component is reported separately when the physician provides only the supervision and interpretation portion of >the procedure. The technical component includes reimbursement for the facility, equipment, film processing, and the >technician. 

You can find the payment in fee schedule. For most of the codes TC compnent payment is high.

Hope that helps!

Cynthia Posted Wed 22nd of November, 2017 12:11:29 PM
ok, so if the doctor owns the x-ray machine then he would bill the modifier 26 along with the x-ray? Our biller has only billed for the x-ray.
SuperCoder Answered Thu 23rd of November, 2017 00:24:11 AM

If doctor owns machine than he would bill the global without any modifier. 


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