CAT Scans, ultrasounds, mammograms and regular x-rays are common in the healthcare system. To a patient, these are normal tests that one may experience during their life. However, in the world of medical billing and coding, these are not any regular test. These and other tests completed by the radiology department are coded unlike most treatments. Radiology coding is often billed by technical and professional components. When components are used is when the total cost of service is separated. By separating the components, the two parties involved can both be compensated or reimbursed for the given service.
Professional component includes the physician who does the necessary steps to interpret the images and write the requesting physician an explanation of findings. While the technical component involves the machines, supplies to capture and record the images, as well as the technician fee. Another definition of technical component is non-physician, anything or anyone associated with the process of the procedure. However, if the capturing machine is owned by the interpreting physician, the total bill …show more content…
This information is critical in deciding if the claim will be a global procedure or if components are necessary. To code only a professional component, enter the proper CPT code and add the modifier 26. To code only a technical component, enter the proper CPT code and add the modifier TC. It is crucial to know how to properly code procedures completed by radiologists because there are a number of rules and regulations to adhere. Medicare usually pays approximately 20 – 25% to professional components and the remainder to technical components. While other health insurance providers reimburse up to a 40/60 split between professional and technical components
Professional component includes the physician who does the necessary steps to interpret the images and write the requesting physician an explanation of findings. While the technical component involves the machines, supplies to capture and record the images, as well as the technician fee. Another definition of technical component is non-physician, anything or anyone associated with the process of the procedure. However, if the capturing machine is owned by the interpreting physician, the total bill …show more content…
This information is critical in deciding if the claim will be a global procedure or if components are necessary. To code only a professional component, enter the proper CPT code and add the modifier 26. To code only a technical component, enter the proper CPT code and add the modifier TC. It is crucial to know how to properly code procedures completed by radiologists because there are a number of rules and regulations to adhere. Medicare usually pays approximately 20 – 25% to professional components and the remainder to technical components. While other health insurance providers reimburse up to a 40/60 split between professional and technical components