Technical vs. Professional Re: [Histonet] 88305 pod lab question

[Cheryl]

Can anyone clear this up with certainty?  We aren't billing MC/MD so Marla may be totally correct on this.  I read the full code book as published last year and didn't come away with quite this same distinction and I would really like to know!
 
Cheryl
 
Full Staff Inc.
Staffing Healthcare Professionals - One GREAT fit at a time.
281.913.7285
800.756.3308


--- On Thu, 10/23/08, Marla Thomas <mthomas <@t> littonlab.com> wrote:

From: Marla Thomas <mthomas <@t> littonlab.com>
Subject: RE: Technical vs. Professional Re: [Histonet] 88305 pod lab question
To: "'Cheryl'" <tkngflght <@t> yahoo.com>, marktarango <@t> gmail.com, Histonet <@t> lists.utsouthwestern.edu, godsgalnow <@t> aol.com
Date: Thursday, October 23, 2008, 6:57 AM

If I am not mistaken, for MD/MC it is the unit performing the technical who
can bill for the global component.  If you only do the professional
component you cannot bill for the technical.  That is why with most POD Labs
they must provide the technical themselves in order to bill globally.

Many of the commercial insurance companies do allow anyone to bill globally
whether they do the technical or not.  In those instances they can
"purchase" the "technical" work to be done somewhere else.

If I am remembering right...

Marla Thomas, HT(ASCP)

Litton Pathology Associates, PC

700 NW Hunter Dr.

Blue Springs, MO 64015

Phone: 816-229-6449 Fax:816-874-4400

 
 -----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Cheryl
Sent: Thursday, October 23, 2008 8:34 AM
To: marktarango <@t> gmail.com; Histonet <@t> lists.utsouthwestern.edu;
godsgalnow <@t> aol.com
Subject: Technical vs. Professional Re: [Histonet] 88305 pod lab question

Hi Mark--
 
The technical and professional on this code are generally bundled.  For most
insurances as well as M/M it can't be split it to be reimbursed (and it
HAS
to be billed by the party performing the professional is my understanding
after just working on this issue a few months ago), Thus the code can be
charged by the path if he or she is subcontracting the technical.  The
technical portion is something ridiculously small, like $12/code.  Chances
are the Pathologist is paying more than this for the tech service. 
 
This is done with frozens all the time where the pathologist is working
for one company  (Path group is independent non-employee entity of a
facility) and the tech who supports them work for the hospital and with
surgical stuff where the pathology group is a contractor for the hospital
that employs the tech...
 
Same animal, different zoo.
 
Cheryl
 
Full Staff Inc.
Staffing Healthcare Professionals - One GREAT fit at a time.
281.913.7285
800.756.3308
 
 
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