Know Your Respective Entities’ TIN to Determine Modifier Necessity
Question: I am extremely new to billing and coding. I work in a family practice where we own our own X-ray machine and our in-house doctor reads the films. Can I bill the technical and professional component separately, or are they supposed to be billed together? AAPC Forum Participant Answer: To answer this, you need to know whether the practice (as owner of the equipment) and the interpreting physician bill under the same tax identification number (TIN) or group. If they do, the X-ray code is typically billed globally, meaning no modifier is required. You’ll also need to consult the payer’s rules, as some carriers/plans have specific place of service (POS) or billing requirements. Modifiers TC (Technical component) and 26 (Professional component) are appended when you are billing only one portion of the service rather than the global service. This most often occurs when the technical and professional components are billed by different entities. For example, if your practice performs the X-ray but the physician who interprets the films bills separately for the interpretation/report, the practice would append modifier TC and the interpreting physician would append modifier 26. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
