Radiology Coding Alert

Increase accuracy by checking equipment ownership

According to CPT Codes, certain radiology codes, such as 75658, require mastery of modifiers -TC and -26 in order to submit clean claims. But not identifying which codes are subject to these modifiers can torpedo your coding. Our experts reveal when you can, and can't, code based on technical and professional components.

Know When to Code Global

If your radiologist interprets a test, and your radiologist or practice owns the equipment and pays the technologist, then you report the "global" code, which means you report the five-digit CPT code without modifier -TC (Technical component) or -26 (Professional component).
 
For example, if the radiologist provides both components of the service, such as the administration and reading for a one-view, unilateral hip x-ray with privately owned equipment, report the appropriate CPT Code (73500, Radiologic examination, hip, unilateral; one view) with no modifiers.
   
Remember -26 for Interpretation and Report

If the physician provides only the interpretation and report for a diagnostic study, you must remember to append modifier -26 to the appropriate CPT code to describe the test, says Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.

Note Equipment Ownership

Don't miss: The facility providing the equipment may claim the technical component of the service (the cost of equipment, supplies, technician salaries, etc.) by reporting the appropriate CPT code with modifier -TC appended.
 
Example: You code for a radiologist who provides services for a hospital, and he does not own his own equipment. Your report indicates an angiography that merits 75658 (Angiography, brachial, retrograde, radiological supervision and interpretation) and 36120 (Introduction of needle or intracatheter; retrograde brachial artery).
 
For the S&I code, you must only bill for the professional service (75658-26), says Marylin Brinkman, CPC, coding specialist for Clarian Health in Indiana. If the radiologist provides the service in a facility, the facility should report 75658-TC to capture the technical component. Red flag: You should not use modifiers -TC or -26 with 36120, Brinkman adds. Surgery codes are pure professional services with no "technical component" involved.
 
Exception: You should never append -26 to 76140 (Consultation on x-ray examination made elsewhere, written report), Brinkman says.
 
Reason: There is no technical component for this code, so you don't have to worry about appending modifiers -TC or -26.