Intra-op flouroscopy

Ccgerson

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Phoenixville, PA
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I've been coding for an orthopedic practice for about 6 months. One of the providers occasionally documents use of flouroscopy intra-operatively with an open surgical procedure. He documents the length of time he operated the fluoroscopy independently. My co-worker says that we can't charge that, only the facility can. I don't see anything in guidelines that specifies whether I can charge it or not. I understand it wouldn't be charged with an arthroscopic procedure, as fluoro is inherent to that procedure. I'm just confused as to why I couldn't charge for it, as it lengthens the time of the procedure when the physician needs to use fluoro.
 

AlanPechacek

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I practiced General Orthopedic Surgery for 40 years, and used intraoperative fluoroscopy for many years, mostly for fracture reduction and fixation procedures, and never charged for the "fluoroscopy time." I documented the use of the fluoroscopy for the procedure, but did not document time. Since I did not "own" the fluoroscopy device/machine used, I couldn't charge for it as part of the/my procedure. The hospital/facility owned the device, and the facility related/contracted Radiologists (much after the fact) read the retained images, created a separate report, and then billed for their services, i.e. the "professional component" (even though their opinion was not needed by myself), and the facility charged for the "technical component," i.e. the use of the device. If your surgeon "owned" the fluoroscopy device himself, and if he rendered a separate Radiological Report/Reading of the retained images from the procedure, then he could probably charge for both the "technical" and "professional" components of the event. Otherwise, I think not.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com
 

amyjph

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Escanaba, MI
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Agree w/ Dr. Pechacek.

Also, if you have the AAOS Complete Global Service Data for Orthopaedic Surgery you can see what is included in the global surgical package.
 
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