Wiki Modifier 26 on Pregnant ultrasounds in Hospital facility

[staz01]

What if the physician does the ultrasound in the hospital, performing and interpretation with complete documentation? The hospital owns the equipement, but the physician did all the work with no assistance from hosptial staff. Do we still have to append the modifier 26?

 

[thomas7331]

What if the physician does the ultrasound in the hospital, performing and interpretation with complete documentation? The hospital owns the equipement, but the physician did all the work with no assistance from hosptial staff. Do we still have to append the modifier 26?

Yes, you do need to use the modifier. Your provider cannot bill a global code since the equipment belongs to the hospital. Some payers' claims systems will catch the error of the missing modifier and pay the correct amount based on the place of service, but leaving off the modifier could potentially cause an overpayment which you'd be responsible for refunding back to the payer.