Wiki Interpretation Of An X-ray


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Hello Out there,

I am currently coding for a neurosurgeon who disagrees with me on the coding for the following scenario relating to his interpretation of MRI and CT's. He feels that if he is called to the ER to evaluate a pt and has to interprate an MRI or CT scan in order to make a decision on how to proceed he is intiltled to bill the appriate 70,000 series code with a -26 modifier attached. I disagree b/c the professional component consists of both interpretation and supervision. I feel his interpretation of the films is part of his medical decision making. Any thoughts out there for me?


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Hello I hope I can help. I code for radiology but not for a hospital. Does your doctor dictate a report? If he does then I do think he should bill for the professional component. The supervision and interpretation is stated in certain radiology codes but not most. I don't believe this is stated in the MRI and CT codes and it's not stated with 26 modifier. Your doctor does need a report to back up his interpretation. Good luck!!!
His "interpretation" is part of the E/M service. Attempting to code a 70,000 series code in addition is double dipping and we know what that means.
I work for hospital-based radiologists. Usually at the hospital, there is a board-certified radiologist on staff who is contracted to read all radiology exams. In this case, you would not be able to bill for the reading of the exam as the ER physician would simply be doing an 'over-read'.. Hope this helps...