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Issue Number - Name
0062 - TC of Radiology Inpatient - FULL
Review Type
Automated
Claim Type
Radiologists and other Part B providers performing radiology services
Region and State
RAC 1-4
All States
Date Approved
2017-09-06

Description

Carriers may not pay for the technical component (TC) of radiology services furnished to patients in hospital settings. Query identifies TC portion of radiology paid  to entities other than the inpatient facility.  Findings are limited to claim lines billed with modifier TC and claim lines for service codes with TC/PC Indicator "1" and/or “3” for TC component only. 

Affected Code(s)

  • No specific codes

Applicable Policy References

  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 13, Section 20.2
  • Change Request 5675
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 26, Section 10.7