92250 Retinal fundus photo in primary care office for diabetics

gski

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Sheridan, MI
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We had a rep from WelchAllyn in our office yesterday presenting the RetinaVue 100 Imager Set. For a fee we can upload and transmit to them the photos to be interpreted & reported back to us. They would supply us with written authorization to bill out the I&R service through our practice. They are advising to bill the 92250, 26 & 92250, TC (as we would own the equipment also). The rep had no idea what I was talking about when I questioned why not just bill a 92250 globally-without modifiers instead of billing with the 26/TC.

My question is, if we have an affidavit stating we can bill the professional component performed by the WelchAllyn Retinal Specialist, would we have to credential them and then bill out the 92250,26 with that providers name, and a separate claim for the 92250,TC? How can you bill out for another contracted provider through your practice when it is not a Locum Tenens situation??

Thank you!!
Gina
 
We had a rep from WelchAllyn in our office yesterday presenting the RetinaVue 100 Imager Set. For a fee we can upload and transmit to them the photos to be interpreted & reported back to us. They would supply us with written authorization to bill out the I&R service through our practice. They are advising to bill the 92250, 26 & 92250, TC (as we would own the equipment also). The rep had no idea what I was talking about when I questioned why not just bill a 92250 globally-without modifiers instead of billing with the 26/TC.

My question is, if we have an affidavit stating we can bill the professional component performed by the WelchAllyn Retinal Specialist, would we have to credential them and then bill out the 92250,26 with that providers name, and a separate claim for the 92250,TC? How can you bill out for another contracted provider through your practice when it is not a Locum Tenens situation??

Thank you!!
Gina


DID YOU FIND YOUR ANSWER AND IF SO, CAN YOU SHARE. We are a PCP interested in this device also.
 
Based on what you wrote in the earlier posts, it sounds like the rep had zero idea of the billing situation. I would bill the 92250 as "plain-jane" global

Maybe the rep thought that you had separate departments do the photos and the reading, like a hospital radiology setting - that's my best guess
 
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