Wiki X-rays and E/M code complexity

[amanda.hodson]

Scenario: clinic takes x-rays and send them out for overreads. Meaning we bill with modifier TC (technical component only). Our providers read the x-rays as well at the visit (same visit X-rays are taken), but because we are getting overread from somewhere else, so we do not bill for this.

Can the provider now use the reading as a point in the Reviewed and Analyzed DATA section of the MDM? or does the TC billing exclude that point from MDM?

Any back up or thoughts appreciated
thank you

 

[TThivierge]

Hi Amanda

This should not invalidate the phys/provider sharing xray and lab results with the patient at visit. It is a point to aid in evaluating with MDM's elements. Also there is dx code to put on last claim if reviewed results with the patient add dx. Z71.2.

This TC modifier is used very frequently in diagnostic radiology CPT codes. For physician side or professional services, one who reads and interprets the report usually has to assign 26 modifier. Technical Component (TC) is assigned when the physician does not own the equipment or facilities or employs the technician. thus, TC does not come into fact with MDM.
I hope I helped you.
Lady T