# modifier 26/tc



## amber97 (Jun 4, 2009)

anybody can explain or help me how to bill 26 and TC in facility setting. our physicians renting an office in hospital, our physicians  own the machine and does the reading and interpretation at the same time ex:92135 and 92136, we simply billed as 92135 and 92136, guess what we got denied by medicare as CO109- claim not cover by this payor... should we bill  line item like 92135-26 on first line and 92135-TC on second line? thank you


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## mitchellde (Jun 4, 2009)

Usually if you are in a designated rural setting then you need to double line bill with the TC on one and 26 on the other.  Otherwise you bill with the global code.. What are you using for the place of service?


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## flacoder2001 (Jun 5, 2009)

amber97 said:


> anybody can explain or help me how to bill 26 and TC in facility setting. our physicians renting an office in hospital, our physicians  own the machine and does the reading and interpretation at the same time ex:92135 and 92136, we simply billed as 92135 and 92136, guess what we got denied by medicare as CO109- claim not cover by this payor... should we bill  line item like 92135-26 on first line and 92135-TC on second line? thank you



"claim not cover by this payor"

I believe this means that Medicare is not the payor. The patient has other insurance coverage. CO-109 means you billed the wrong payor, check patient's eligibility.


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## amber97 (Jun 8, 2009)

*mod 26 and tc*

i forgot to mentioned that we got paid when we added mod 26 but we are trying to get reimburse on mod tc as well do you think we can add to the next line with mod TC. 

at Mitchellde we use place of service 22
at Flatcoder we are aware of that but that was not the case because we got paid when we add mod 26 they just wont pay for global code, that's why i am asking what is the best way to code


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## mitchellde (Jun 8, 2009)

Yes add the TC to a separate line entry you cannot put 26 and TC on the same line.  Your POS is correct so then are you in a rural setting?  If so then that is how you will need to bill all your radiology to Medicare.


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