Advanced Search

Orthopedic Coding Alert

Dodge Double-Billing Interp Claim Mishaps With This Advice

Published on Sat Apr 25, 2009

You may not always be able to report CPT code, but discover this big benefit. When your orthopedist does the interpretation for magnetic resonance imaging (MRI), computed tomography (CT) scan, or other diagnostic test, you may run into hospital policy specifying only a facility radiologist can perform the interpretation. If so, coding your orthopedist's interpretation would mean you-re guilty of double-billing. But it's not all bad news. When the orthopedist cannot bill separately for the interpretation, you can still consider the test as a factor in medical decision making when assigning an E/M level. Avoid This Double-Billing Danger Zone Before billing for any diagnostic test interpretations in an inpatient setting, be sure that another physician hasn't already laid claim to the service, says Beth Thomsen, billing coordinator for the University of Toledo Physicians, LLC, in Ohio. Scenario: The patient has suffered a blow to the head and displays symptoms of [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Orthopedic Coding Alert

View All