Question: Should our practice bill IOL biometry with modifiers -TC for the technical component and -26 for the professional component?

Answer: If you own the equipment and perform the interpretation, submit CPT code 76519 or 92136 for the first eye. Some payers require modifiers -RT or -LT indicating the surgical eye; others do not. For Medicare Part B payment, the technical component is inherently bilateral and the professional component is unilateral. When billing for the second eye, when the second eye surgery is performed, append modifier -26 and the eye modifier.

If another practice performs the professional component only, they should bill with modifier -TC indicating they only performed the test. The surgeon who determines the IOL power should submit 92136 or 76519 with modifier -26 indicating only the professional component. Z

Learn more about testing services in eLearning: Testing Services Documentation Requirements.