TC PC FOR PATH REPORTS

HOWRU2DAY

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If a dermatologist does a biopsy and sends to outside lab who provides the technical component and sends the diagnosis to the dermatologist would this be a global charge (for the lab) ? or would the dermatologist bill with a 26 modifier? I have read about TCPC programs and am very confused.

Thanks,
 

danachock

Guru
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Hi HOWRU2DAY,
I'm simply confused with this post. When a dermatologist performs a procedure and performs a biopsy, they will submit this to the pathology department for the Doctor's ~ yes, a pathologist's "professional interpretation" that will be billed with modifier 26 on the majority of their charges.
I am unsure what type of scenario I have, but when the provider does the biopsy in this scenario they are the provider billing the technical (facility) fee(s). The TC or xxxxxF charges. I am unsure where you are billing from or what hospital/clinic scenario to tell you if or whether you should be billing global.
If you could provide a little more information please, I may be able to help.
Thanks for listening,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
 

thomas7331

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If a dermatologist does a biopsy and sends to outside lab who provides the technical component and sends the diagnosis to the dermatologist would this be a global charge (for the lab) ? or would the dermatologist bill with a 26 modifier? I have read about TCPC programs and am very confused.

Thanks,
Normally, when a tissue sample is sent out, the lab will prepare a slide (which is the technical component) and then a physician will view the slide under a microscope, make a diagnosis and prepare a report (which is the professional component). So if your lab is sending back the diagnosis to the dermatologist, that means that a physician associated with the lab has already performed the professional component, and likely the lab is billing this as a global charge. The dermatologist would only bill for the pathology with a 26 modifier if they were the individual who personally reviewed the sample after the slide preparation and made the diagnosis. This usually requires that the dermatologist have specialized training in pathology and is qualified to perform that component. In my experience, most general dermatologists do not have this training and do not perform their own professional components of pathology work, although dermatologists who are Mohs surgeons do have this capability. Hope this helps some.
 
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