Radiology Coding Alert

Question: For a skilled nursing facility (SNF) patient, can we code R0070 for portable x-ray transportation? We perform 93970 (Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study) and 93971 (... unilateral or limited study). If Medicare doesn't cover the portable imaging services, will the SNF cover it?


Connecticut Subscriber
Answer: If you meet Medicare's requirements for covering portable x-ray services for SNF patients, you may report this code to Medicare if you served a Part B patient. Snag: Carriers typically want to see a 70000-range code to pay for R0070 (Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen). Duplex scans don't fall in this category.

Best bet: Obtain a signed ABN to bill the patient for the portable charge if Medicare doesn't reimburse for the expense of providing the portable service.

Medicare may cover diagnostic portable x-ray services under Part B in a SNF if the service is performed under the general supervision of a physician. According to Pennsylvania Medicare carrier HGSA, for example, covered services are very limited:
  skeletal films involving arms, legs, pelvis, vertebral column, or skull
  chest films that don't involve contrast media use
  abdominal films that do not involve the use of contrast media
  transportation and set up on eligible diagnostic portable x-ray services
  standard electrocardiogram
  mammographies, must be a certified mammography center (www.hgsa.com/professionals/bguides/pf-xray.shtml).
 
Remember: If you do perform a covered service, if the patient is covered under Part A, arrange for payment with the SNF. Medicare will pay the SNF, and the SNF will pay you. Only report R0070 to Medicare if the patient is in a Part B stay.