Author Topic: pathology billing for modifier 26 component  (Read 6321 times)

JLBJODY

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pathology billing for modifier 26 component
« on: August 30, 2010, 05:15:16 PM »
Hello, I'm trying to determind the correct answer to the following question. On pathology services, the modifier 26 component place of service would be what - if the sample is collected at an ASC? The place I work for is saying that the pathologist 'read' it should be POS 24 = ASC but I'm saying the actual services where the pathology is performing the services is at the laboratory not the ASC therefore would be POS 81. Any help would be most appreciated. jlbjody

oneround

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Re: pathology billing for modifier 26 component
« Reply #1 on: August 30, 2010, 06:32:23 PM »
A pathologist may perform a gross and microscopic examination of an ovary, code 88305, during a surgery in a hospital. Under the circumstance that this pathologist bills independently, the hospital would bill the technical component 88305-TC, and the pathologist would bill for just services using the code 88305-26, billing for just the interpretation and the pathology report.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

Michele

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Re: pathology billing for modifier 26 component
« Reply #2 on: August 31, 2010, 11:19:09 AM »
but would the pathologist use 81 for the POS?  Or 24?  I think 81.
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medauthor

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Re: pathology billing for modifier 26 component
« Reply #3 on: August 31, 2010, 12:51:17 PM »
Hmm..I would go with the POS of where the 26 component actually took place; where was it 'read and interpreted'?
Michelle Rimmer, CHI, CPMB
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oneround

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Re: pathology billing for modifier 26 component
« Reply #4 on: August 31, 2010, 01:29:41 PM »
Correct, if the interp was done by an independent then POS of 81 for your independent would be your lucky charm
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

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Re: pathology billing for modifier 26 component
« Reply #4 on: August 31, 2010, 01:29:41 PM »

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Re: pathology billing for modifier 26 component
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Re: pathology billing for modifier 26 component
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