Global xray billing and MDM credit for viewing film


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Our group has Xray on site and we bill global. In addition to this my MD's (Orthopaedic surgeons) are insistent on getting credit in the EM MDM for ordering Xray (1pt) as well as independently viewing the Xray (2 pts) when the patient has an Xray done on site and on the same visit. My opinion this is double dipping...their position being that the Xray is a seperate and independent service that has nothing to do with the thought process that goes into the decision to order the xray (I agree with that and happily give 1 pt for that) or the independent viewing/use of the film in their MDM to base their treatment on. That in providing the xray service and billing global in itself addresses only the facility cost (Tech component) and the individual MD's liability for the read (professional component)

Can anyone out there direct me to a source that addresses and gives guidance on this specific issue? I have searched CMS, AAOS and AMA.

Obviously there are alot of opinions out there, but I need a reputable source that I can quote to help my argument. I am really struggling with this and want to do the right thing...


Pensacola, Fl
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From my understanding "getting credit" for any MDM would be considered an E&M service, and not applicable in the global period. I run into this with my surgeons, and what I've been able to get them to understand, that with owning the x-ray equipment we are being paid for the technical component and the read of the xray, (there's nothing else we can bill for). Manual/Surgery.pdf (just in case it didn't save from the title.