Question Modifier TC

mrbleil

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My co-workers and I are discussing when it is appropriate to use Modifier TC. They are saying that TC is an institutional modifier and therefore cannot be applied if the service is provided in a physicians office. I think that if the physician's office owns the xray equipment, and provided the service and it is documented, but the report or reading of the results is not documented it would be correct to bill the radiology code with the TC modifier. Who is correct?
 

wisibyusha

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If a provider, for example owns an x-ray equipment and performs a two view x-ray and the x-ray is interpreted by another specialist located in another office; the primary care provider reports the x-ray code with HCPCS level ll modifier -TC and the other specialist who interpreted the x-ray reports the professional component using modifier -26. So you are correct.
 

thomas7331

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What if an outside company performs the test, using their equipment but is using one of the practice's exam rooms. Can the practice bill for use of the exam room? And what modifier is used?
The use of the room is included in the payment for the technical component - there is no way to itemize that out by coding it separately. If the practice is incurring significant costs due to the outside company's use of their space, then the practice may want to consider charging that company a fee for the service.
 

SharonCollachi

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You must see your provider ordered the service or not.
Every Hospital acquires its own equipment if the physician/employee of the orders the X-ray and interprets the same you no need to append any modifier.
Some clinics doesn't have own equipment and have an X-ray from the technician. he just review and interpret the X-ray findings- this is professional Service 26.
Meanwhile Technician may bill the service with TC so the bill is Splitted, hope this may also helps.
I must admit, I have no idea what you are trying to say, if you are adding something different than has already been said.
 
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What if an outside company performs the test, using their equipment but is using one of the practice's exam rooms. Can the practice bill for use of the exam room? And what modifier is used?
 

csperoni

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I second Thomas' advice. If an outside company is using your office space (their own equipment and staff), they should be paying you rent for the space being used. It should generally be done at fair market value, by which you calculate the amount of space they are using, and the amount of time, and they pay that percentage. For example, if they use 20% of your space 2 days per week and you are open 5 days a week, then it would be 20% (amount of space) x 40% (the amount of time) x the expense (rent, utilities, etc).
I know when we sublet space, the whole legal department needed to draw up a 20 page document. If you are a private practice, you can do it more simply, but it does need to be fair market value to maintain Stark compliance. I imagine there's some variance allowed, but it cannot look like you are giving them free space or grossly overcharging as a kickback. Or at least that's what the legal department told me.
 

Orthocoderpgu

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Our clinic has an -ray machine as they are orthopedic surgeons. Yes, you could bill an X-ray with a -TC if the interpretation is not documented, but if its missing we send it back to the physician to document that.
 
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