Wiki TC modifier in internal medicine..Help?

[Limbanidd2012@gmail.com]

TC modifier billable in internal medicine. Is it true?
please let me know if any one have brief idea for the same?

 

[thomas7331]

Yes, if the physician owns, operates the equipment and supervises the technicians performing the services, then they can bill the TC modifier.

 

[Limbanidd2012@gmail.com]

Thank you for your response!!
I have one more question for the same.
Now the situation is, we have one physician group. In office visit one technician performed radiology and for interpretation they are sending reports to physician and they both are in different state.

So can we code like;

Ex: 77067-26 or 77067-TC

26 or TC which is more preferable for payment. How both will get payment??

 

[thomas7331]

Thank you for your response!!
I have one more question for the same.
Now the situation is, we have one physician group. In office visit one technician performed radiology and for interpretation they are sending reports to physician and they both are in different state.

So can we code like;

Ex: 77067-26 or 77067-TC

26 or TC which is more preferable for payment. How both will get payment??

77067-TC would be billed by the office or facility where the mammogram was done. 77067-26 would be billed by the physician who read the images and did the interpretation. There is no overlap between the TC and the PC, so both will be paid.

 

[Limbanidd2012@gmail.com]

Do you have any notes or links where they give the detailed description that we can bill both TC and 26 together in one documentation?
We need to send it to the physician because they need proof for the same.

Your help means a lot!!
Thanks!!

 

[sls314]

Do you have any notes or links where they give the detailed description that we can bill both TC and 26 together in one documentation?
We need to send it to the physician because they need proof for the same.

Your help means a lot!!
Thanks!!

If the same physician is providing both services, you would just bill globally. You wouldn't need to use the TC or the 26.

All the TC and 26 do is split up the payment amount when different providers need to be paid for the technical and professional components.

Example:

The fee schedule amount for 77067 is $134.34.

If different providers performed the technical and professional components, they would be paid $37.69 (77067-26) and $96.65 (77067-TC). The total payment made would still be $134.34. The modifiers just tell which provider needs to get which portion of the amount.

If the same provider performed the technical and professional component, they would bill the global service and be paid $134.34.

You'd never need to bill -26 and -TC on the same claim for the same service.

 

[Limbanidd2012@gmail.com]

If the same physician is providing both services, you would just bill globally. You wouldn't need to use the TC or the 26.

All the TC and 26 do is split up the payment amount when different providers need to be paid for the technical and professional components.

Example:

The fee schedule amount for 77067 is $134.34.

If different providers performed the technical and professional components, they would be paid $37.69 (77067-26) and $96.65 (77067-TC). The total payment made would still be $134.34. The modifiers just tell which provider needs to get which portion of the amount.

If the same provider performed the technical and professional component, they would bill the global service and be paid $134.34.

You'd never need to bill -26 and -TC on the same claim for the same service.

Thanks a lot!!