Wiki Technical and professional components

[mjewett]

Hi,
I need a refresher on billing technical and professional components for an echocardiogram (93307)

This is our situation:
We are a surgical office, we own the equipment, and will perform the test. (TC, right?)

We will be having a cardiologist, who is not employed by us interpret the results. He would bill (26 right?)

Does anyone know how you handle this situation? What if the Cardiologist who will be doing the interpretation, and who is not our employee, doesn't want to bill. Wants only to be paid a flat rate by us for his services.

Thanks,

 

[sbicknell]

If you do the test and an external physician does the interp and report, then code
you.....93307-TC
ext Phys.....93307-26


If you do the test and an external physician does the interp and report. BUT you have a contract to pay this physician a flat-fee for every one he does the interp report, then code
you.....93307
ext Phys.....no coding, just pay him is contracted fee

Basically on the 2nd scenario, goes back to the old rule of purchased services. You pay him and you code/bill the complete service

Lots of rules and guidelines. Here is a link with some info
http://www.hcpro.com/CCP-245994-557...ces-and-in-with-the-new-antimarkup-tests.html

 

[mjewett]

Thanks for the info.

Ok my next questions:

1. We will be contracting with a Technician to perform the echos. Does anti- mark up or purchase test rules apply to a tech?

2. If a tech performs the echo who's name goes on the claim for billing? The owner of the equipment is not always going to be in the suite while service is being performed.