When physicians provide diagnostic services, payer policy may dictate not only codes and modifiers to be reported but other important information deemed necessary for proper claim payment.
Many diagnostic services may be performed and billed by a single practitioner performing the complete service or split between 2 practitioners, with one billing for the technical component of the service and the other the professional component. Medicare and most payers use modifiers 26 (professional component) and TC (technical component) to describe the professional and technical components of service when the components are separately performed and reported. No modifier is necessary when one entity performs both components.
A patient has a 2-view chest radiograph taken at an outpatient radiology practice and transports the films to the physician’s office for interpretation. The physician performs the interpretation and report. This service is reported as follows:
The outpatient radiology practice would report 71020 TC for the...