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Reimbursement Advisor

The setting determines code for nonstress test

May 2006 · Vol. 18, No. 5
This week's quiz:
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<huc>Q</huc> Can I bill a nonstress test (NST) 59025 with TC (Technical component) as a modifier?

<huc>A</huc> A physician never uses the -TC modifier, even if he or she personally performed the NST. If this procedure is performed in the hospital, the -TC modifier is reported by the hospital for the use of the equipment.

The physician reports the service with modifier -26 (Professional component).

If the procedure is performed in the office setting and the physician owns the equipment, code 59025 is billed without modifiers, as it represents both technical and professional components.

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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