Bill Modifier TC Lately? Expect a Letter
Practitioners, medical groups and clinics, and independent diagnostic testing facilities (IDTFs)—or any eligible professional who has billed for the technical component (TC) of a CPT® advanced diagnostic code in the past six months, for that matter—can expect to receive the first of five letters from a Medicare contractor by Aug. 13. The letter is a reminder that they must be accredited by Jan. 1, 2012 to continue furnishing advanced diagnostic imaging services to Medicare beneficiaries.
Advanced diagnostic imaging includes magnetic resonance imaging (MRI), computed tomography (CT), and nuclear medicine imaging such as positron emission tomography (PET).
The Centers for Medicare & Medicaid Services (CMS) states in the letter: “Since we expect it can take up to nine months from the time you initiate the accreditation process to completion, we urge you to begin the accreditation process for advanced diagnostic imaging services as soon as possible.”
CMS approved three national accreditation organizations—the American College of Radiology, the Intersocietal Accreditation Commission, and The Joint Commission—to provide accreditation services for suppliers of the TC of advanced diagnostic imaging procedures. The accreditation requirement applies only to the suppliers of the images themselves, and not to the physicians interpreting the images.
CMS July 9 Transmittal 727 replaces July 2 Transmittal 726 to change the implementation date and July 2010 reporting requirements so contractors have sufficient time to mail this first round of the notification letter to affected providers. Standard X-ray code 72200 Radiologic examination, sacroiliac joints; less than three views has been removed from the list of CPT® codes because it isn’t considered an advanced diagnostic imaging service.
Other diagnostic imaging types excluded from this accreditation requirement include ultrasound, fluoroscopy, and mammography.