Wiki ERCP with Radiologic supervision and interpretation

rlmiller

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I have a physician that is coding an ERCP (43260-43273) with the imaging of the ductal systems (74328, 74329, 74330), however I found out that the radiologist group is also coding the imaging (74328, 74329, 74330). All the articles that I have found state that only one physician can code for the imaging when performed on the same date. This makes since to me, however my physician is stating that he should bill for it and not the radiologists. The radiologist group is out of the hospital and the GI physician is not owned by the hospital. So the procedures are performed in the hospital setting, we the GI group bill for the professional component of the procedure. The radiologist is billing for the reading of the imaging study and the hospital will bill for for all the facility charges.

Are there any GI groups out there that bill for both the ERCP and imaging and found out that the radiologist groups are also billing for the imaging? I am concerned this is compliance nightmare.

Thank you.
 
Tina Cade, CPC, CGIC

The radiology portion cannot be billed by the physician if the radiologist has already read it and it sounds like that is the case.

:eek:
 
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