Global Billing
These diagnostic tests include situations where the same physician performs the test and interprets the results. When billing globally, the physician must have either:
* Personally performed both the professional and the technical components, or
* Personally performed the professional component and supervised his or her own employee(s) who performed the technical component.
Technical Component Only
These diagnostic tests include situations where the physician performs the test but does not interpret the results. Physicians should indicate modifier TC (technical component) on the claim form to identify these services.
Professional Component Only
These diagnostic tests include situations when the physician interprets but does not perform the test. Physicians should indicate modifier 26 (professional component) on the claim form to identify these services.
Purchased Technical Component
A technical component purchased from an outside supplier should be submitted as a separate item on a claim. Claims for purchased technical services must include modifier WU (purchased test) and the name, address, and Medicare provider number of the supplier rendering the test. The amount paid to the supplier for the test must also be indicated on the claim in block 20 of Form CMS-1500 or the designated electronic field. Failure to provide all required information will cause denial of the claim. If more than one supplier is used or more than one test purchased, separate claims must be submitted.
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