Urology Coding Alert

Question: Can my urologist charge for reading a retrograde urethrocystogram (74450) done in radiology department in a hospital setting?

Ohio Subscriber

Answer: If the radiologist is not present in the x-ray/radiology room to read the films, and there is no hospital policy against a non-radiologist billing for reading the films, the urologist performing the study and interpreting the films may bill.

Use the following coding for this scenario:

• 51610 (Injection procedure for retrograde urethrocystography) for the performance of the retrograde urethrocystogram by the urologist and,
  
• 74450 (Urethrocystography, retrograde, radiological supervision and interpretation) for the interpretation of the study. Append modifier 26 (Professional component) to 74450 to indicate that the urologist is billing only for the interpretation and does not own the equipment. The hospital should only bill for the use of the equipment with 74450-TC (Technical component).
  

If the hospital policy (by-laws) only permits a radiologist to bill for the full radiological services, then the urologist should only bill for the injection of the contrast agent with 51610.