Skip to Main Content
Issue Number - Name
0123-Techincal Component (TC) of Diagnostic Procedures during an Inpatient Stay
Review Type
Automated
Claim Type
Physician/Non-Physician Practitioner, Independent Diagnostic Testing Facility (IDTF)
Region and State
RAC 1-4
All A/B MACs
Date Approved
12/11/2018

Description

When billed on the same date of service as an inpatient hospital claim, the Technical Component (TC) of diagnostics is not payable to the Part B provider. The technical component is performed by the facility while a patient is in a covered Part A Inpatient Stay.

Affected Codes

CPT Code Range 10000-99999 (Excluding CPT Codes 70000-89999) with PC/TC Indicators of 1 and 3 

Applicable Policy References

Social Security Act: Section 1833     

CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, Addendum-MPFSDB File Layouts, 2011-2018 File Layout    

CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, Section 30 

CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 30.1