What is purchased professional component in Medical billing

Purchased Professional Component 

A professional component (interpretation) of a diagnostic test purchased from an independent physician or medical group will be reimbursed only if:

* The tests are initiated by a physician or medical group that is independent of the person or entity providing the tests/interpretations;
*The person or entity requesting payment submits a claim;
*The physician or medical group providing the interpretation does not see the patient; and
*The purchaser (employee, partner, or owner of the purchaser) performs the technical component of the test. The interpreting physician must be enrolled in the Medicare Program.

The supplier must identify, in the appropriate claim fields, the name, address, and Medicare provider number for the physician providing the interpretation.

For all purchased services, the acquisition cost (the amount paid for the service) must be provided to the carrier, in block 20 of Form CMS-1500 or the designated electronic field. Failure to provide this information will cause denial of the claim.
The purchaser must keep on file the name, the provider identification number, and address of the interpreting physician.

Note : The ordering physician ’ s name and NPI must be shown on all diagnostic test claims.

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