Neurology & Pain Management Coding Alert

Question: Our neurologist reads polysomnograms, sleep studies, and EEGs. Should we code by the date the tests were performed, or should we code with the date that the neurologist reads and dictates the report?

Texas Subscriber

Answer: Most payers request that providers code with the date the test or tests were performed so they can potentially match the two separately reported components -- your providers professional interpretation services reported with modifier 26 (Professional component) appended and the facilities technical component reported with modifier TC. Even if your neurologist is not always able to read the reports the same day the procedure is done, modifier 26 simply clarifies that he provided only the professional component of the diagnostic study.

Remember: Always ask, Does your carrier have specific rules on this? If so, go by the carriers rules.