Wiki Modifier 26 &TC

[mzdarren36@gmail.com]

Hi,
I am needing a basic coding question answered. There seems to be some confusion regarding who get the 26 modifier and TC modifier when it comes to Radiology services when done in the hospital.
The tech does the X-ray and the Radiologist reads the X-ray and then the doctor goes over the results with the patient. Would the radiologist get the 26 modifier?

 

[sls314]

Hi,
I am needing a basic coding question answered. There seems to be some confusion regarding who get the 26 modifier and TC modifier when it comes to Radiology services when done in the hospital.
The tech does the X-ray and the Radiologist reads the X-ray and then the doctor goes over the results with the patient. Would the radiologist get the 26 modifier?

The 26 modifier is for professional services. The radiologist who read and documented the report would bill for their time and clinical expertise. That's the professional service.

The TC modifier is the technical component, which is billed by the entity that owns the x-ray machine. The entity is getting reimbursed for the expense of using the machine.

The physician who goes over results with the patient does not bill for the x-ray. Depending on the circumstances, it could be factored into the Evaluation & Management level. (For example, if the physician was providing an independent interpretation, or making other medical decisions based on the x-ray result.)