Orthopedic Coding Alert

Question: How do I bill for intraoperative x-rays?

New Jersey Subscriber

Answer: Intraoperative x-rays are those taken during surgery and read by the physician during the surgical session. Since an x-ray technician is present in the operating room to take the x-rays, the physician can bill for the professional component only. The technical component, or the taking of the images, is billed by the hospital. When you submit your billing for the surgery, include the appropriate code for the x-rays and append modifier -26 (professional component). A word of caution, however: According to CPT radiology guidelines, a written report signed by the interpreting physician should be considered an integral part of the radiologic procedure or interpretation. If your surgeon does not dictate a radiology report (frequently, orthopedic surgeons do not at the hospital), it would be inappropriate to bill for the professional component of the x-ray.