Wiki Modifier TC

[BMICHAUN]

Is it appropriate to add modifier TC to pathology codes on facility claims UB04, if so can you give documentation to support this

 

[CodingKing]

No, it automatically assumed to be the technical component only when billed on UB-04

 

[karamac]

I would check with the commercial carrier on their policy. If the code allows for TC modifier, and it is itemized then it can be appended to the UB-04. This is especially important if you are only billing for the Technical and the professional is outsourced.

AHA while the owner of the UB-04 does not define or restrict how a CPT code is appended to the form. So if it is compliant coding to add a modifier to a CPT code on a UB-04 then my recommendation is to add it. Transparency is the best policy.

 

[thomas7331]

Most payers will not reimburse a professional fee on a UB-04 claim, and the very few that do will require that the professional fees be billed under a different revenue code which will identify it as such. (The TC of a pathology will be billed with revenue codes 0310-0319 whereas the PC would use revenue code 0960-0989). Standard practice across the industry is to bill and pay all professional services using the 1500 form - to do otherwise is a very rare exception.

So I think there is very list risk in omitting the TC modifier from UB-04 claims because, as CodingKing says, it is understood that this is what is being billed on a UB claim. But there is also likely no harm in adding if you feel it is necessary or your payer requires it.

 

[BMICHAUN]

Thank you