Forum - Questions & Answers

Jun 25th, 2014 - Kedwardsx1 2 

Lumbar puncture

How should I bill 62270 when a neurologist does the whole procedure and just uses a facility. He does not use fluro so the facility is using 62270 TC should I bill with a 26 modifier or which one.

Jun 25th, 2014 - LBAROGIANIS 250 


You would just bill the code on a CMS 1500 form. The hospital should just bill the code on a UB04 form. The insurance company knows that they will get two bills, one for the surgeon and one for the facility.

Mod 26 is usually when there is a third party involved. Ex: X-rays..

Jun 25th, 2014 - CodapediaMsgBoard 96 


Agreed. The doctor will get paid less based on the practice expense because the place of the service is the hospital. You would not use 26 because the provider is doing all of it. The TC is when there is equipment owned by the hospital or some entity other than the billing provider or practice.

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