tci Medicare Compliance & Reimbursement - 2007 Issue 42

LABS: Let MPFS Status Indicators Show You How To Get Paid

Harness fee schedule policy rules for the PC/TC modifiersThe Medicare Physician Fee Schedule just shows reimbursement levels for pathologist procedures, right? Wrong. We'll show you how to decipher the MPFS for technical/professional component billing conventions to make sure you get the correct pay--every time.The MPFS holds the key to payment when you bill for the professional and/or technical components of certain pathology procedures. Two fee-schedule columns provide "payment policy" indicators regarding which services involve professional and/or technical components and how to use modifiers to report the work:1. PC/TC: The PC/TC (professional component/technical component) indicator column has 10 possible...

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