Sandeep Posted Thu 07th of March, 2019 06:10:31 AM
Which DOS can be reported for TC and 26 modifier for VCE. Our client is submitting 91110-TC on day 1 and 91110 - 26 on any other day for the same patient under same POS. Is this correct? Should the billing be under global fees without any modifier ?
SuperCoder Answered Fri 08th of March, 2019 04:45:09 AM
In the CPT code 91110, the provider gives the patient an activated endoscopic capsule to swallow with normal water. Natural peristaltic movement assists the movement of capsule through the digestive tract. As the capsule passes through digestive tract, it automatically takes color images of the gastrointestinal lumen. The provider places several image recording sensors on the patient's abdomen. An antenna at the base of the capsule sends the images to the recording device. The provider leaves the patient for eight hours while the image recording takes place. A complete procedure requires image recording from upper esophagus to the terminal ileum. The provider may also take images of the colon. The capsule passes out with a bowel movement within a day after completion of procedure. The provider transfers the data from image recording device to the computer. He then analyzes and interprets the recorded data and prepares a written report. So, physician can interpret and make the report on the different date, but date of service of the procedure will remain same.
If you are reporting only the professional component for the service, you should append professional component modifier 26, Professional component to the code.
If you are reporting only the technical component for the service, you should append technical component modifier TC to the code unless the hospital provided the technical component. In that case, do not append modifier TC because the hospital’s portion is inherently technical.
Do not append a professional (Modifier 26) or technical modifier (Modifier TC) to the code when reporting a global service in which one provider renders both the professional and technical components.
A “global” service includes both the professional and technical components of a single service. When reporting a global service, no modifiers are necessary to receive payment for both components of the service.
NOTE: Physicians providing services for Medicare patients in a hospital or facility setting cannot claim the technical portion (modifier TC) of a procedure.