Billing Office Diagnostic Tests in 2010 Becomes More Difficult!

The Centers for Medicare & Medicaid Services (CMS) announced new billing requirements for all tests having both a professional and technical component, e.g., x-rays, ECGs, etc. (This change DOES NOT apply to clinical laboratory tests).

Effective with dates of service on or after January 4, 2010, the appropriate date of service for the professional component is the ACTUAL calendar date that the interpretation was performed. For example, a single view chest x-ray (technical component) is performed on January 5, 2010 but the physician does not do interpretation until January 11, 2010, you must split bill the service!

01-05-2010           71010-TC
01-11-2010           71010-26

You do NOT have to individually itemize the components when the test is performed and interpreted on the same calendar date.

Start creating your process now to identify when the physician actually interprets tests performed in your office. It is not necessary to actually start splitting claims until January 4, 2010, but you will need to develop a process to identify those tests that are interpreted (including written interpretation) on the same day vs. tests that are performed on one day and interpreted on a different calendar day.