Neurology & Pain Management Coding Alert

Interpreting Test Results

Question: If a neurologist orders a radiological test such as a CT scan or an MRI, and he or she also looks at the films in addition to the radiologist, can the neurologist be reimbursed for reading the films?

Yvonne Stodulste
An Illinois Subscriber

Answer: If the radiologist already has provided an interpretation of a CT scan or MRI, the neurologists review of the report is included as a part of the neurologists decision-making in the evaluation and management service. If the neurologist felt that there was a significant discrepancy in the findings of the original report and he met all the requirements of documentation for the radiological test, then he could bill for an interpretation using the appropriate CPT code with modifier -26 attached.