Tenn. Comp. R. & Regs. 0800-02-17-.08 - TOTAL PROCEDURES BILLED SEPARATELY

(1) Certain diagnostic procedures (neurological testing, radiology and pathology procedures, etc.) may be performed by two separate entities that also bill separately for the professional and technical components. When this occurs, the total reimbursement shall not exceed the maximum medical fee schedule allowable for the procedure code listed.

(a) When billing for the professional component only, modifier 26 (Professional Component) shall be added to the appropriate procedure code.

(b) When billing for the technical component only, modifier TC (Technical Component) is to be added to the appropriate procedure code.

Notes

Tenn. Comp. R. & Regs. 0800-02-17-.08

Public necessity rule filed June 5, 2005; effective through November 27, 2005. Public necessity rule filed November 16, 2005; effective through April 30, 2006. Original rule filed February 3, 2006; effective April 19, 2006. Repeal and new rules filed November 27, 2017; effective February 25, 2018. Administrative changes made to this chapter on September 10, 2019; "Tennessee Workers' Compensation Act" or "Act" references were changed to "Tennessee Workers' Compensation Law" or "Law." Amendments filed June 27, 2023; effective 9/25/2023.

Authority: T.C.A. §§ 50-6-128, 50-6-204, and 50-6-205 (Repl. 2005).