What does Modifier -26 signify when reporting a service?

What does Modifier -26 signify when reporting a service?

• A. Technical portion of the service
• B. Provider's interpretation and report
• C. Multiple procedures performed
• D. Decision for major surgery made

Answer: (B)

Modifier -26 is used to indicate that only the professional component of a service has been provided, which typically encompasses the provider's interpretation and report of diagnostic tests or procedures, such as imaging studies. When billing for services like radiology, pathology, or certain laboratory tests, this modifier signals that the healthcare provider is charging for their intellectual and interpretative work rather than any associated technical components, which are billed separately. In the context of the choices provided, the option referring to the provider's interpretation and report aligns precisely with the use of Modifier -26. This distinction is crucial in coding, as it helps to clarify the nature of the service being billed and ensures proper reimbursement for the services rendered, separating the professional assessment from the technical aspects of the procedure.

Modifier -26 is used to indicate that only the professional component of a service has been provided, which typically encompasses the provider's interpretation and report of diagnostic tests or procedures, such as imaging studies. When billing for services like radiology, pathology, or certain laboratory tests, this modifier signals that the healthcare provider is charging for their intellectual and interpretative work rather than any associated technical components, which are billed separately.

In the context of the choices provided, the option referring to the provider's interpretation and report aligns precisely with the use of Modifier -26. This distinction is crucial in coding, as it helps to clarify the nature of the service being billed and ensures proper reimbursement for the services rendered, separating the professional assessment from the technical aspects of the procedure.