Hello, I'm posting this question here because apparently there is no radiology forum. I work for a large provider network, doing radiology coding. When I get my reports, they tell me what code or codes the hospital billed, and then the actual report follows. I had one recently that stated that a non-OB abdominal US was performed, along with an endovaginal US, procedures 76856 and 76830. The report, however, detailed a gestational sac with a heart beat and everything else necessary to bill an OB US. I was told by my manager that because the hospital billed 76856 and 76830 with modifier -TC, that we need to bill the same codes with -26, or we'll have issues with the insurance company.
My feeling is that this is going to be a payer-specific thing, but can anyone tell me how to find some CMS guideline somewhere that details the proper way to handle this? I feel like in this case, I should have billed 76815 and 76817 instead. Any help would be greatly appreciated. Thank you all.
My feeling is that this is going to be a payer-specific thing, but can anyone tell me how to find some CMS guideline somewhere that details the proper way to handle this? I feel like in this case, I should have billed 76815 and 76817 instead. Any help would be greatly appreciated. Thank you all.
