Wiki Professional/Technical component - Lab codes

[kajalgaonkar16]

I need help with laboratory codes getting denied as "payment based on professional/technical component." ,
Examples being - 87653, 80061, 83036, 82947

How do I resolve such denials?

 

[thomas7331]

Would need more information to be able to help. Are you getting this denial on a 1500 professional claim or on a UB-04 facility claim? Are you billing these with modifiers 26 or TC? What place of service are you using?

 

[kajalgaonkar16]

The place of service is 11.
It is a 1500 professional claim.
Billed without any modifiers

 

[thomas7331]

The place of service is 11.
It is a 1500 professional claim.
Billed without any modifiers

If that's the case, then the denial makes no sense to me. Clinical lab tests do not have professional/technical components, so I have no idea what the payer is saying here. I think you would need to contact them for additional information or an explanation. Sorry not to be more help!