Wiki mod 26 and MRIs

[mjb5019]

My CEO is stating that since the pains doctors "read" the patients MRI's that
the patient brings in I should add the MRI codes with mod 26. I contend that
since the MRI center has already billed for the professional component we cant bill it. Any one with any references to this would be greatly appreciated

 

[jbaird]

If the radiologist has already billed globally for the exam, you are correct. The insurance will deny your claim as already paid to another provider.

 

[cmcgarry]

I agree with Jill. However, since they are viewing the actual images, and not just the report from the radiologist, it will count toward amount/complexity of data to be reviewed for Medical Decision Making. That's how I explained to the doctors I worked with that they really were getting "credit" for viewing the images.