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Hospital

Wesley Posted Mon 28th of December, 2015 11:49:26 AM

Hi we have a provider who is a sub-contractor with a Hospital. She does all her surgeries there and bill global charge. We have an example where she did a 58558 and 58300. Our provider was the attending provider during these procedure, we billed for 58558 and was paid for. Can the hospital bill 58558 and 58300 with TC modifier? even though our provider did all of the technical and professional component?.

SuperCoder Answered Tue 29th of December, 2015 08:54:54 AM

Thanks for the Query

When the technical component of a procedure (personnel, materials, equipment, space and supplies) is rendered by a health care provider other than the physician performing the professional component of the procedure, the provider shall bill the technical component by adding modifier TC to the appropriate procedure code.As per the coding guideline for modifier TC is not applicable with CPT 58558 and 58300.

Wesley Posted Thu 31st of December, 2015 10:05:52 AM

The hospital billed those two codes with TC modifiers and was able to get paid.

SuperCoder Answered Mon 04th of January, 2016 06:42:19 AM

Thanks for the Query

As mentioned in my last reply it is inappropriate to use Modifier TC with these cpt but if hospital getting paid for the same then you can go for the same.

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