Physician(s) may bill for inpatient professional interpretation(s), when thatinterpretation serves as the official and final report documented in thepatient’s medical record. Professional interpretation may be billed inaddition to a hospital visit if the rounding physician also is responsible forthe documentation of the final report for the procedure in the patient’smedical record. The procedure code must be billed with modifier 26(Professional Component) and modifier CG (Policy criteria applied)appended.
Physician(s) may not bill for inpatient professional interpretation(s) inaddition to hospital visits if the provider reviews results in the medicalrecord or unofficially interprets medical, laboratory, or radiology tests.Review and interpretation of such tests and results are included in theevaluation and management of the inpatient. Medicaid will cover either onehospital visit or professional interpretation(s) up to the allowed benefit limitfor most services.