Pediatric Coding Alert

Technical and professional components hold your clues.What do insurers expect for documentation of tympanometry or other diagnostic tests? That's the question Pediatric Coding Alert subscriber Paula Escobar with Riverside Pediatric Group asked, so we went looking for answers.Starting point: Payers' expectations depend partly on the procedure and associated CPT code, specifically whether the procedure has both professional and technical components or a technical component alone, says Catherine Gray, RHIT, CCS, CPC-I/Cardio/GI, a medical services auditor with the Henry Ford Health System in Detroit. Read on for examples on how to handle each type of case.Two Components Equals Multiple RecordsIf the test includes the full range of services, verify the pediatrician's portion before coding the case. Example: A chest x-ray (71020, Radiologic examination, chest; 2 views, frontal and lateral) includes both technical and professional components. If you're reporting only the technical component, report 71020 and append modifier TC (Technical component); if [...]