Wiki Sleep Study (for Cardio patient) w/Pulmonology interpretation

[paigehaase]

Cardio meets with patient and gives equipment with direction of use 95800 with Mod -TC
Patient brings back equipment and Cardio downloads report

Pulm picks up report and does interpretation 95800 with Mod -26


But, if Total Recording Time (TRT) is less than 6 hours, Pulm also adds a Mod -52 for reduced services.
The question remains if Cardio needs to add Mod -52 to their charges even if their work was done when handing off equipment.


We cannot find definite answer to this and want to bill correctly.

 

[nrood]

Our sleep studies used to be done at a sleep center and certain machines could be taken home by the patients. Our facility (hospital) used to bill for the use of the equipment and/or facility and the Pulmonary office would bill for the interp. Both locations would append the 52 modifier, if the patient didn't use it for the whole 6 hours. The facility used to also bill for 2 dates, if done as a home study, since the equipment was used overnight.