Wiki Mri read only

[mieie4444]

I am an orthopaedic surgey office and my physician whats to bill for read only of MRI's that are done elsewhere and read by their physician. My question is : since we do not do the MRI here in our office and they have been read by another doctor can my physician also bill for a read only? The patient brings the MRI with them along with the report from where they have been read by the radiologist at the MRI office.

Thanks
Sharon

 

[moleskpl]

You might find your answer here although you probably will need to reasearch a little to see if any rules have changed since this post back in 2008: https://www.aapc.com/memberarea/forums/archive/index.php?t-8646.html

Here's a recent (2012) post about re-reads which might also give you some good information. I believe there is a link in one of the responses: https://www.aapc.com/memberarea/forums/archive/index.php?t-76445.html

 

[halebill]

Since I asked that original question in 2008, we have just included the re-reading of the MRI in the E/M service. Although my Dr would view the MRI images, he was not necessarily interpreting and reporting on them in such a way that would qualify as a "professional component" of this service.


Bill Hale, CPC

 

[moleskpl]

The radiology group I used to work for was always being asked to perform CT & MRI over-reads for some of the other practices (usually neurology, neurosurgery) & the rads would dictate a letter with their report but would not bill. In recent years, the practice admin started billing for these over reads which were always denied for no prior auth, even though billed with -26 modifier for interpretation only. When not denied for prior auth the claims were denied as duplicate. It was a no-win situation. I've been gone from there over a year now so I'm not sure how they are handling this now.

 

[soprano]

I am an orthopaedic surgey office and my physician whats to bill for read only of MRI's that are done elsewhere and read by their physician. My question is : since we do not do the MRI here in our office and they have been read by another doctor can my physician also bill for a read only? The patient brings the MRI with them along with the report from where they have been read by the radiologist at the MRI office.

Thanks
Sharon

You cannot bill twice for the professional component. If your physician wants to personally view the MRI, he may but this would be included in the E/M service. This would count under MDM data points for independent review of image, tracing, or specimen. Hope that helps.