Sunday, April 10, 2011

RADIOLOGY TEST COMPONENTS - Professional and technical component

RADIOLOGY TEST COMPONENTS

Most diagnostic radiology services are a combination of a physician or professional component and a technical component. Medicare payment for most radiology services includes both the professional and technical components for the procedure code that is billed. Billing for both the technical and the professional components is called “global billing.” Modifiers are used to indicate if only the technical component or only the professional component is being billed. However, other procedure codes are specific to a global billing, only the technical component or only the professional component. The Medicare Physician Fee Schedule Database provides instructions on when the use of modifiers for billing separate test components is appropriate. Refer to the section for additional information.

Professional Component (Modifier 26)
When the physician component is reported separately, the 26 modifier must be added to the procedure code. The payment includes the physician’s work, practice expense and malpractice expense.
The interpretation of a diagnostic procedure includes a written report.

Correct Date of Service (DOS) for the interpretation of diagnostic tests:
* Actual calendar date that the interpretation was performed.

Technical Component (TC) (Modifier TC)

When the Technical Component (TC) is reported separately, the TC modifier must be added to the procedure code. The payment does not include any physician work Relative Value Units (RVUs). Refer to the section “Physician Supervision of Diagnostic Tests” for complete information on requirements for physician supervision for the technician who may actually perform the tests.

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