Tuesday, September 10, 2013

Mod 26 Vs. TC


Modifier 26 Vs. TC

CPT modifier -26 represents the professional (provider) component of a service or procedure and includes the provider work, associated overhead and professional liability insurance costs. This modifier corresponds to the human involvement in a given service or procedure.

Correct coding guidelines require that modifier -26 be used when the professional component of a global service is the only service provided (i.e. supervision and/or interpretation codes.)

HCPCS Level II modifier -TC represents the technical component of a service or procedure and includes the cost of equipment and supplies to perform that service or procedure. This modifier corresponds to the equipment/facility part of a given service or procedure.

Correct coding guidelines require that modifier -TC be used when the service provided represents only the equipment or facility component of a global service and not the professional component of the same service. Hospitals frequently provide only the technical component of some services. Hospitals are not currently required to submit the -TC modifier, but will be reimbursed as if the -TC had been billed.

Modifier 26 signifies the Professional Component whereas TC modifier signifies the Technical Component.Professional Component is the examination and interpretation of the specimen and whereas the Technical Component refers the the details analysis of the specimen.