Otolaryngology Coding Alert

Clip-and-save audiology reimbursement guide

You can get paid for audiology services even when your practice doesn't perform all responsibilities, if you use modifier -26 or -TC.
 
These modifiers indicate that you are reporting the professional (-26) or technical component (-TC). When your otolaryngologist interprets the audiology test, you should claim the professional component. If he also owns the equipment and employs the audiologist, you should report the technical component. When the claim meets all three criteria - the physician interprets the report, owns the equipment and employs the audiologist - make sure to assign the global code, the unmodified test code.
 
Each component reimburses at a percentage of the global code. For instance, 92585 contains a total 2.70 relative value units. The professional component has 0.74 RVUs, and the technical side has 1.96 RVUs. Add the two sides together, and you get the total 2.70 RVUs that 92585 has.
 
Be careful: Before you report individual services, make sure the test contains these components. You may use modifier -26 or -TC for the following 10 audiology codes.