Wiki Telehealth xrays

[kimmcelderry@gmail.com]

Hi there,
I work for an ortho clinic so we have our own xray equipment. We normally bill out xrays without a modifier for in-office visits, but with telehealth the patient came in a few days earlier for xrays. We are receiving denials for billing xrays with a TC mod when the pt physically comes in and with a 26 mod during the telehealth visit. Does anyone have any insight on how we should be billing this? I feel that billing the full xray code on the day of the telehealth visit is not accurate since we took the xrays on a different date.

Thank you for your help.

 

[SharonCollachi]

Medicare's guidance:

Typically, radiology services have two separate components: a professional and technical component. These services will have a PC/TC indicator of “1” on the Medicare Physician Fee Schedule (MPFS) Relative Value File. The technical component is billed on the date the patient had the test performed. When billing a global service, the provider can submit the professional component with a date of service reflecting when the review and interpretation is completed or can submit the date of service as the date the technical component was performed. This will allow ease of processing for both Medicare and the supplemental payers. If the provider did not perform a global service and instead performed only one component, the date of service for the technical component would the date the patient received the service and the date of service for the professional component would be the date the review and interpretation is completed.