Forum - Questions & Answers

Jul 2nd, 2020 - sschwartz 4 

cpt 77002 professional componet with cpt 20610, who charges?

Our new Orthopedic is now doing hip injections 20610 with fluoroscopic guidance 77002. He does this over at the hospital who owns our clinic. There is a question now of who bills for the 77002 mod 26. As far as I can find it appears the provider who does the injection with the guidance would code it with the 20610. However our radiology department says they are to bill the 77002 mod 26 for the radiologist who does the report/read of the procedure. They already code the 77002 TC for the facility charge. So who is supposed to bill the professional component? the doctor who does the guided injection or the Radiologist?

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Jul 9th, 2020 - ChrisW   178  1 

re: cpt 77002 professional componet with cpt 20610, who charges?

If the Physician did the work, he would bill the 26 - Professional Component Modifier, If the procedure was done in a facility owned by someone other than the Physician, then the Facility would bill the TC - Technical component. See the descriptions below.

26 - Professional Component
Certain procedures are a combination of a physician or other qualified health care professional component and a technical component. When the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.

TC - Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances, the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles

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Jul 15th, 2020 - sschwartz 4 

re: cpt 77002 professional componet with cpt 20610, who charges?

I realize those two things about the professional vs the technical. My question involves a third party who thinks they are to get the professional fee. The radiologist who writes the report of what the guidance showed. The girl who bills out his charges says as he "did the read/report" that he should charge the professional component with mod 26. But our Orthopedist who did the injection using the guidance is who I thought was to charge for it. I realize it won't be paid twice by the insurance for two separate providers. so my question is does our doctor who did the injection bill the professional component or the radiologist who wrote the report?

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Aug 6th, 2020 - ChrisW   178  1 

re: cpt 77002 professional componet with cpt 20610, who charges?

The information below came from our on-staff auditor, I hope this helps.

"It's a therapeutic injection performed by the physician using a C-arm that results in multiple images that are documented by him in the operative report but he is using the facilities equipment. So, the 77002-26, 20610 is billed by the physician while the hospital bills for the equipment use 77002-TC"

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