Mod -26

[CCO-support]

Howdy,
I know it's simple but for some reason I have a "mental block" when I'm dealing with "Professional component" Gurrrrr
I become confused when or when not to use it. What I do know is, when it is stated in the code "with physician supervision, with interpretation and report" we do not require the modifier.
Do we use -26 when the physician owns the equipment or when the facility owns it? Also is this to increase the physician payment or to decrease the payment?
I am writing my CPC board exam this Saturday.
Thanks for your time and all the information I have learned from you!
Jana

 

[Ruth Sheets]

Laureen covered this in the July 2012 Medical Coding Certification Q & A webinar. She said to remember that -26 decreases the payment. If the physician owns the equipment and does the "read", the physician deserves to get both the technical and professional components, so do not use -26. If however, it the physician does not own the equipment, and is just doing the "read", use -26.

View the replay at www.cco.us and click on Q and A Webinar Replay link. This is a replay club so you get access to all the past replays as well as future ones.

 

[Danielle]

also a thread was just started on this subject too https://www.cco.us/forum/threads/radiologic-s-i-question.104/

 

[Laureen]

Thanks Danielle - I knew that sounded familiar ;-)