Which of the following is true about the professional component 26 modifier?

• A. It is used to identify the professional component of radiology work
• B. It indicates a surgical complication
• C. It denotes a remote interpretation
• D. It marks a test as experimental

Answer: (A)

The concept being tested is how radiology services are billed when they have two parts: the professional component (the radiologist’s interpretation) and the technical component (the actual imaging performed by the facility). Modifier 26 is used to identify the professional component. Attaching it to the CPT code signals that you’re billing for the physician’s interpretation part only, separate from the facility’s technical component. This helps ensure the radiologist’s interpretation is paid if the technical work is billed separately with the appropriate modifier (TC for the technical component). If the entire study is billed as a single global service, there’s no need for the 26 modifier. It isn’t used to indicate a surgical complication, remote interpretation (that uses telemedicine modifiers instead), or an experimental test.