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Issue Number - Name
0090 - TC of Lab/Pathology for Outpatient Hospitals
Review Type
Automated
Claim Type
Professional Services (Physician/Non-Physician)
Region and State
RAC 1-4
All States
Date Approved
2018-02-13

Description

The technical component (TC) of lab/pathology services to patients in an outpatient hospital setting are not separately payable. Findings are limited to claim lines billed with TC/PC indicator “3” for the TC component only.

Affected Code(s)

  • All Lab/Pathology CPT/HCPCS codes with TC/PC indicator 3 and/or CPT/HCPCS modifier TC

Applicable Policy References

  • Title XVIII of the Social Security Act, Section 1833
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 23