# 78452-26?



## Jfrank (Jan 26, 2010)

We are reciving denials for using 78452 with modifier 26. I've been looking for an answer for 2 days now and haven't seen it referenced here yet. We are being told you can't split the code with a 26. Is there a more appropriate code just for reads?
The tests are preformed in the hospital and the reads are done in his office.


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## agott (Feb 3, 2010)

I had a conversation with Medicare yesterday and was told if you have a 21 or 22 POS then the 78452 with 26 modifier will process correctly if you have a 11 POS they are stating that you can not separate the code. 
I was getting a rejection regarding the 78452 stating invalid POS, we read the test for a outpatient testing center, and they stated that because it was a 22 POS I needed a 26 modifier on the claim, which I thought I had but did not. And that was when she told me about the POS situation.  Hope that helps.


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## cmcgarry (Feb 16, 2010)

Even though the reads are done in his office, you still use the hospital location and the -26 modifier, because the tests were done at the hospital.  That should help with the denials.


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