when we bill professional component and techinical component or global component

Professional and Technical Components

Some procedure codes in the 70000, 80000, 90000, and G series are a combination of a professional component and a technical component. Therefore, these codes may be billed one of three different ways; (1) as a global, (2) as a professional component, or (3) as a technical component.
NOTE: Not all providers are allowed to bill any or all of the three ways to bill. Specific coverage questions should be addressed to the Provider Assistance Center.

• Global, the provider must own the equipment, pay the technician, review the results, and provide a written report of the findings. The procedure code is billed with no modifiers. The Global component
should be billed only for the following place of service locations:

− 11 (Office)
− 81 (Independent Laboratory)

• Professional component, the provider does not own or operate the equipment. The provider reviews the results, and provides a written report of the findings. The Radiological professional component is
billed by adding modifier 26 to the procedure code, and should be billed only for the following place of service locations:

− 21 (inpatient hospital)
− 22 (outpatient hospital)
− 23 (emergency room - hospital)
− 51 (inpatient psychiatric facility)
− 61 (comprehensive inpatient rehab facility)
− 62 (comprehensive outpatient rehab facility)
− 65 (end-stage renal disease facility)
− 81 (Independent Laboratory)

• Technical component, the provider must own the equipment, but does not review and document the results. The technical component charges are the facility’s charges and are not billed separately by
physicians. The technical component is billed by adding modifier TC to the procedure code. The technical component can only be billed by facilities

No comments:

Medical Billing Popular Articles