Wiki Coding X-Rays and U/S and the readings

[brandytony]

I work at a medical office where we offer x-rays and u/s on site. We do the x-ray and/or u/s and then we contract with an outside provider to read the x-rays and u/s. We pay them for their services. The outside provider will bill Medicare and Medicaid for the reading they do directly but we bill for all other 3rd party insurance and private pay for the readings. What is the proper way to code this? I need to code the procedure and the reading. Would I need to code it separately since 2 different providers are providing the service? Please help.

 

[balamuruganm]

You should code CPT with TC Modifier (XXXXX-TC) and Outside provider only interoperate the report so he will code CPT with 26 modifiers ( XXXXX-26)

 

[brandytony]

How about the readings that he does not charge for. We pay him to do them but he does not do any billing except the Medicare and medicaid.