PET Scan Denial**BILLING QUESTION**

We just gained a contract for global rates for PET Scan services, I understand the negotiated rate is technical component, professional component, and FDG inclusive.

So we billed the PET Scan service 78812 modifier TC and modifier 26.

The payer denied our claim after many calls to provider relations they stated it is being denied because I am billing both components and we are contracted globally.

This is our first contract we have a global rate on. So my question is how do I bill it? Without modifiers?

All of our other contracts are only for the technicaly component. So confused and I pretty sure I am over thinking it.

Any help is greatly appreciated.

Yes, no modifier

the modifier is only if you are billing a portion of it- technical or professional. If you bill the whole thing, no modifier. You probably should separately bill the FDG, knowing you will get denied, so that you are consisent in always billing contrast on scans, unless you can be sure no others are slipping thru unbilled.