Split billing question

1. FNAs (fine needle aspirations) CPT - 10022 w/ultrasound guided needle placement CPT - 76942

With non-Medicaid/Medicare patients we bill the 10022 and 76942 without a TC or 26 modifier as we own the ultrasound machine and our doctor both performs the service as well as interprets the results.

Our billing office is questioning whether they need to put a TC or 26 modifier with split billing patients, if so how does it get entered.

The following are interpretations that our doctor does:

1. Radiopharmaceutical therapy - 79005,26 - he verifies the dose and writes a report (we use the 26 modifier because we are only doing the professional component).

Is this the same way we should enter for split billing?

2. Thyroid uptake and scan 78006,26 - he interprets the report only therefore we use the 26 modifier for the professional component

Is this the same way we should enter for split billing?

Thanks for your help

Split billing question

What do you mean by split billing in this situation?

Fna

Billing for Medicare/Medicaid

split billing

Do you mean you have a PA or NP performing part of the servce?

Fna

All aspects of the procedure/US/interpretation are done by the MD

US guidance

See codes 10022 and 76942.
You did not note the site of service, office or facility.

Split Billing

Sorry all of these procedures are done in an outpatient setting which is a dept of a hospital that bills for both facility and professional components

facility setting

diagnostic tests performed in a facility setting require the 26 modifier on the code unless it has a specific code for the supervision and interpretation.
So, the radiology code will need modifier -26

FNA and modifiers

I think I understand the question, but still wonder who owns the ultrasound equipment.

Your first post said that you owned the equipment.
If you own the equipment, and take it to the hospital outpatient department, and your MD performs the ultrasound (or your MD's staff person) then you would bill 10022, and 76942 with no modifiers.

If the hospital owns the equipment/hires the tech, then you would bill 10022 and 76942-26, and the hospital would bill 76932-TC.

Make sure that there is a picture from the ultrasound machine (the results) in the chart to bill 76942-TC and an interpretation (the report) from your doctor to bill 76932-26, and both to bill globally.

Split billing

Thank you for your response, I believe we are doing it correctly -- just to clarify we own the equipment and the equipment is in our outpatient office, there are no techs involved and all the images are retained in the PACS system and results of the procedure are dictated into our EMR system.