The dreaded Modifier 26

[Darlene]

I am studying to take my CPC on December 8th. I struggle with Modifiers 26 and TC. Just when I think I get it, I don't....lol. I did my coding course online so I didn't have the blessing of a teacher in front of me giving me the tips and explanations in an easy way that I could understand. I am now doing the CPC study guide and I have finished the Blitz videos but will go over them again before the big test. So, here is my question...when coding the radiation treatment management codes (specifically 77427), do they require the use of modifier 26? I put it on my practice question and got it wrong....do they ever require the modifiers and, if so, in what circumstances. Thank you in advance for your help. Oh, and cystourethroscopies get me every time...lol. Never knew there was so much involved in those...lol

Darlene

 

[Meg]

Darlene, Medicare payment policy stipulates that the professional interpretation of port films is part of weekly treatment management (CPT® code 77427). However, the technical component is reportable using CPT code 77401 - 77416. Therefore no modifier is required for these services.

Hope this helps.
Meg

 

[Laureen]

Great answer Meg - thanks!

 

[Darlene]

Thank you very much.....sometimes I get confused by what the notes are saying.