Practice Management Alert

Question: A patient suffered a blow to the head and displayed symptoms of dizziness, sleepiness, slurred speech, and confusion. To check for internal injuries and aneurysm, the attending doctor ordered a CT scan (70460), which revealed no evidence of serious injury. My doctor then admitted the patient for observation. Can I bill for the interpretation?

Louisiana Subscriber

Answer: No. In a hospital or other inpatient setting, a facility radiologist or other physician may provide interpretations for all ordered tests as a matter of policy. Therefore, as the admitting, but not attending/ordering, physician's biller, you cannot report the interpretation for 70460 (Computed tomography, head or brain; with contrast material[s]).

Only one person should read the diagnostic test, and the person billing for it should have a complete report. If your physician reads the films/fluoros and bills for them, then you need to have a separate note with a separate signature at the end of the op or office note.

Bottom line: If one physician interprets a test and provides a report outlining the result, no other physician can bill for the same service. This would constitute double-billing.

You probably could not report the CT scan interpretation for your doctor in the above scenario because, very likely, the hospital radiologist would prepare the initial report for the CT scan. Even when your doctor provides the immediate interpretation used for treatment and the radiologist provides an "over-read" (secondary quality assurance review), hospital rules may give the charge to the radiologist.