TC Modifier on TOB 013X

I am hoping to get some clarification on billing -TC modifiers on a facility claim.  We currently bill for the facility component of services such as Radiology, Lab & Pathology on a TOB 013x, with the appropriate revenue code but we don't add a -TC modifier on the claims. I found conflicting information that stated that billing without the -TC is considered "global" even if billed on a TOB 013x.  The issue here is that we don't want to be billing "global" because the physician bills his professional component separately under his own TID. I have always understood that -TC and -26 modifiers are unnecessary on UB claim and thought it was assumed to be technical only when billed of a hospital claim.  Does anyone have any resources or guidance on this issue?  I would really appreciate any assistance or validation.

Comments

  • We have to map TC modifiers to the insurances that require the modifier. So MCR will always pay TC based on the Rev code. But we have to map our CDM for BCBS MVP MCD and MCD managed cares with a TC modifier otherwise they will pay global. I would check with your REPS to verify that this is what they want.
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