Wiki TC modifier - I work for a Family Practice that owns

[nc_coder]

I work for a Family Practice that owns their xray machine. Our physicians read the xrays in the office and give a preliminary report, but then send out to a Radiologist for the official report. Should I be using the TC modifier?

 

[Kisalyn]

I code for a family practice that owns their x-ray machines. We have an arrangement where all results are sent to a radiologist to perform the official report. All of our radiology codes go out with the TC modifier. The radiologist bills for the professional component.

Not sure if that helps any.

 

[trarut]

Oncology practice here rather than family practice but we do have xray, CT and PET scanners. We also contract with an outside radiologist for the report so we bill our radiology services with a TC modifier.

Hope this helps!

 

[bdunca1]

This is a timely post.

I studied for and recently took the CPC-H exam. On both the practice and actual exams, there was a question about the use of the TC modifier in outpatient radiology departments. Per the practice exam, the answer is that TC is not appropriate to use in an outpatient radiology department so this is what I answered on the exam, but this is not consistent with my understanding of what happens in practice.

I am presuming that an outpatient radiology department is affiliated with a hospital (i.e., an outpatient hospital department). Typically, the hospital billing office would not bill for the professional services of the radiologists performing the read and interpretation so the hospital would add TC when billing for servies from the outpatient radiology department.

Is this consistent with others' understanding? Do you have thoughts on why the AAPC study materials exams indicate that TC is not appropriate for use by a outpatient radiology department?

Thank you for your input.