Pulmonology Coding Alert

Question: Can I bill for a professional component when a pulmonologist orders an arterial blood gas test?

Answer: No. CPT Assistant tells us that a physician may only bill for the professional component of a laboratory test (e.g., medical direction, supervision or interpretation) when the technical and professional components are performed by different providers.

The physician fee schedule from Medicare (MPFSDB) shows when codes have both a technical (modifier TC) component and a professional (modifier 26) component that may be billed separately. Arterial blood gas test (ABG, 82800-82810) does not. In fact, the PC/TC column of the blood gas code database tell us that the "concept of a professional/technical component does not apply."