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pathology billing for modifier 26 component
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JLBJODY
Newbie
Posts: 1
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
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oneround
Full Member
Posts: 226
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.
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Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare
Michele
Administrator
Hero Member
Posts: 5927
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
Full Member
Posts: 129
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'?
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Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections
oneround
Full Member
Posts: 226
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
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Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare
Medical Billing Forum
Re: pathology billing for modifier 26 component
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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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pathology billing for modifier 26 component