Clarify These Coding Components
Question: How do I look at a code and know if it can be billed with both a professional and technical component? Idaho Subscriber Answer: You can check for a PC/TC (professional/technical) indicator in the Centers for Medicare & Medicaid Services (CMS) FS lookup tool and see how this is listed for each code with an indicator. You will begin by searching for the code you are looking for. Once you have that information, you can scroll to the right to get more details on your code. For example: Code 93244 (External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation) has a PC/TC indicator of 2, meaning it’s a professional component only code. According to CMS, an indicator of 2 “identifies stand-alone codes that describe the physician work part of chosen diagnostic tests for which there’s an associated code that describes the technical component of the diagnostic test only and another associated code that describes the global test. An example of a professional component only code is 93010 [Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only]. You can’t use modifiers 26 [Professional component] and TC [Technical component] with these codes. The total [relative value units] RVUs for professional component only codes include values for physician work, practice expense, and malpractice expense.” You can find the full definitions for each indicator here. Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
