Keyword Analysis & Research: mod 26 testing

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Frequently Asked Questions

What does mod 26 mean on a billing code?

Modifier 26 is used with the billing code to indicate that the PC is being billed. Generally, Modifier 26 is appended to a procedure code to indicate that the service provided was the reading and interpreting of the results of a diagnostic and/or laboratory service.

What is modmodifier 26 used for?

Modifier 26 is used when only the professional component is being billed when certain services combine both the professional and technical portions in one procedure code. The PC (Professional Component) is the supervision and interpretation portion of the procedure, and includes indirect practice and malpractice expenses related to that work.

What is the modifier 26 for professional component?

When the professional component of one such procedure is performed separately, the specific service performed by the physician may be identified by adding modifier 26 professional component. Let’s break that down a little further.

When to use a 26 as a lab code?

The only laboratory codes I have found that require (or are able to use) a 26 are on pathology, histochemistry, histocytopathology. These all require a review by the pathologist therefore, a 26 is appropriate. The codes you mentioned are not normally reviewed by a pathologist and are interpreted by your PCP. (this is my opinion).

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