The physician who interprets the X-ray submits a claim with modifier 26 appended (ie, 71010-26). The clinic will append modifier TC to the appropriate chest X-ray code (eg, 71010-TC, Radiologic examination, chest single view, frontal-technical component) to account for the cost of supplies and staff. The total RVUs for 74020 are 1.04, of which 0.66 RVUs are attributed to the technical component and 0.38 are attributed to the professional component.Ī chest X-ray is performed in a freestanding radiology clinic, and a physician who is not employed by the facility interprets the films. Note that the separate relative value units (RVUs) assigned for the technical and professional components will equal the total RVUs for the global service (described below). The second line details the technical component only, and the third line describes only the professional component. The first of these lines corresponds to the "global" service. The most recent file as of September 2015 can be found at If the Relative Value File lists separate line items for a code with modifiers 26 and TC, the service or procedure described by that code includes both a technical and professional component.įor instance, the 2015 Relative Value File lists three separate lines for 74020, Radiologic examination, abdomen complete, including decubitus and/or erect views. The surest way to identify codes with separate professional and technical components for Medicare payers is to consult the National Physician Fee Schedule Relative Value File, available as a free download from the Centers for Medicare & Medicaid Services (CMS) website. Consult individual payers for specific coding instructions. Hospitals typically are exempt from appending modifier TC because it is assumed that the hospital is billing for the technical component portion of any onsite service. Fees for the technical component are reimbursed to the facility or practice responsible for these costs. To claim only the technical portion of a service, append modifier TC, technical component, to the appropriate CPT code. The technical component of a service includes the provision of all equipment, supplies, personnel, and costs related to the performance of the exam. Modifier 26 is appropriate when the physician supervises and interprets a diagnostic test, even if he or she does not perform the test personally. To claim only the professional portion of a service, CPT Appendix A ("Modifiers") instructs you to append modifier 26, professional component, to the appropriate CPT code. The professional component is provided by the physician, and may include supervision, interpretation, and a written report. Most radiology services or procedures, although described by a single CPT code, comprise two distinct portions: a professional component and a technical component. Radiology Billing and Coding: Professional and Technical Components
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