Wiki Modifier 26 and TC

[cdcoder]

I hope someone can help us with this. We are Anesthesia providers. If we perform needle placement with USG in an ambulatory facility - can we bill 76942-TC if we own the ultrasound equipment? We have been billing with the 26 modifier for the professional component, but would it be appropriate to bill for the technical component or both? Thanks!

 

[thomas7331]

I hope someone can help us with this. We are Anesthesia providers. If we perform needle placement with USG in an ambulatory facility - can we bill 76942-TC if we own the ultrasound equipment? We have been billing with the 26 modifier for the professional component, but would it be appropriate to bill for the technical component or both? Thanks!

No, if you're billing a facility place of service, a technical component on a professional claim will be denied. It's the responsibility of the facility to provide all technical services as that's inclusive to the surgical case rates they are paid.

If it's your equipment being used there, then the facility should be either reimbursing you directly for this, or else providing their own equipment for your providers to use while they're there.

 

[cdcoder]

Thank you so much!