kathleeng
Guru
Question, can a specialty office that has imaging onsite for their patients accept external referrals for scans without getting established with one of the providers first?
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Wiki Accepting external referrals for imaging
- Thread starter kathleeng
- Start date
rstroup
Contributor
From my previous experience working at a surgery clinic that had their own CT machine, we did accept outside referrals from surrounding providers for imaging services. As I recall, we billed under one of the providers (usually whomever was in clinic that day) and would list the ordering physician in box 17. We only billed the technical component since the images were read by a radiologist at the hospital.
Hope this helps!
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Ryan Stroup, CPC
Hope this helps!
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Ryan Stroup, CPC
This may be more of a question of whether they should even if they can, particularly if the scans are read by the specialist.
If the specialty office does not have radiologists, it would seem odd for an orthopedist to accept a referral from a PCP for an xray only. What would occur if the orthopedist saw a fracture?
What if the external test is looking for something a bit beyond the scope of the specialist? Example: specialty office is GI and performs CT scans. However, the patient's abnormality is in the bladder. Is a GI the best person to evaluate a CT scan examining the bladder?
If after thinking about this, your practice wants to proceed, you should get legal advice from an experienced attorney regarding this as well as ensure this action is covered under the physician's malpractice coverage.
If the specialty office does not have radiologists, it would seem odd for an orthopedist to accept a referral from a PCP for an xray only. What would occur if the orthopedist saw a fracture?
What if the external test is looking for something a bit beyond the scope of the specialist? Example: specialty office is GI and performs CT scans. However, the patient's abnormality is in the bladder. Is a GI the best person to evaluate a CT scan examining the bladder?
If after thinking about this, your practice wants to proceed, you should get legal advice from an experienced attorney regarding this as well as ensure this action is covered under the physician's malpractice coverage.