Radiology Coding Alert

Question: Because radiopharmaceuticals (RPs) are so unstable, practices like ours must order these materials the day before the procedure. They cant be saved for another day. We recently had a patient who broke his appointment at the last minute, so the RPs werent used and had to be disposed of. Can we submit the charges or bill the patient for this?

Virginia Subscriber  
Answer: Unfortunately, there is nothing you can do about the expense of the unused radioisotopes under most insurance contracts. Usually these contracts state that if your radiologist did not provide the service or inject the isotope, you cannot charge. The best way to avoid this situation is to impress upon the patient the importance of keeping appointments and explain how a broken appointment results in the wasting of expensive materials.
 
Some practices ask the patients to sign an agreement prior to ordering the radiopharmaceutical, stating they will reimburse the practice if they are unable to keep their appointment. Because of the costs, however, the patient may be upset by this request and go to another facility to have the test performed rather than sign the statement. Radiologists choosing this course of action must understand they may recover the cost of the radiopharmaceutical but lose patients. Of course, legal counsel should review any such agreement before it is incorporated into practice policy.
 
-- You Be the Coder and Reader Questions were reviewed by Donna Richmond, CPC, radiology coding specialist with Acadiana Computer Systems Inc., a medical billing management company based in Lafayette, La., that serves more than 200 radiologists, pathologists and anesthesiologists.