Wiki Modifier 26 on 77001 and 76937

[zaidaaquino]

Our surgeon is performing services at a hospital as an out patient service. The ins denied both 77001 and 76937 stating that the surgeon could only bill the professional component, not the technical component. Can anyone offer any insight into this? Should the surgeon only bill the professional component when these services are done at the hospital?

 

[CodingKing]

Technical component is a facility expense thus the UB-04 from the Hospital will covers the TC component. 26 component should be billed by the physician. If you were to bill for the global charge that would be double dipping.

For example on 77001, the facility employs the technician and own the equipment. Image below is the practice expense break down (click on thumbnail for full size):

 

[zaidaaquino]

Thank you Coding King for your reply.

Zaida