CPT Professional and Technical Components

[Valerie]

I need help in lamine terms what this is saying I think I may be confusing myself:

If a diagnostic test or radiology service is billed twice by any provider, once without modifier 26 or TC (indicating the global service) and once with modifier 26 (Professional component) or TC (Technical component), then deny the lines billed with modifiers 26 or TC with reason Procedure Inappropriately Coded. Modifier Exception Package Applies. Additional exception: 92136 and 76519, Modifiers -76 and -77.

 

[Laureen]

Right - once you bill it with no modifiers you have in essence billed for the 26 and TC in one shot. Going back and billing again with a modifier 26 is like asking to get paid twice for the professional component.

 

[Valerie]

Thanks Laureen... I swear sometimes I think too deep and just confuse myself!!!

 

[Laureen]

We all do it - at least you're willing to ask and figure it out. Some hold to their view no matter what! Happy coding!