Orthopedic Coding Alert

Question: We own our x-ray equipment and take all our x-rays in the office. The x-ray technicians are employees of the practice. One of our physicians was told at a seminar that we should be billing our x-rays with modifier -26 (Professional component) and that dictating the x-ray report as part of the operative note is wrong. Is this correct?

Florida Subscriber

Answer: It sounds as if the seminar speaker was referring to practices that do not own their own x-ray equipment.

If your office owns its x-ray equipment and employs the technicians, and if the physicians do the interpretation of the films, report the code for the x-ray study that was performed (e.g., 73120, Radiologic examination, hand; two views) without a modifier. By reporting the global charge, you are indicating that you provided both the technical and professional components of the service.

For the x-ray report, CPT guidelines state, "A written report, signed by the interpreting physician, should be considered an integral part of a radiologic procedure or interpretation."

CPT does not specify that the report must be a separate entity, only that it be signed.