Wiki OV & Xrays

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kimt

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My clinic is running into Office Visit & XRAYS that are not being paid on same visit. We are using your standard LT/RT modifiers for the Xray. Is there an additional modifier we should be using to make sure the OV & the Xray are paid.

Thank you for any information.
Kim
 
I just bill OV and X-ray with LT/RT just like you and there hasn't been a problem. What kind of denial message are you getting?
 
The denial is stating that the Xray is a combined service that is part for the visit. They are stating that the 'benefit of this service is included in the payment/allowance' We are getting this on 99214 & 99203 but not the 99024.
 
The only thing I could think of is maybe because of the place of service you use.
And do you do the xrays right there (do you own the equipment)?
 
That is one possibility also, I have worked with several ortho physicians recently that have been audited for the xrays and money was recouped by the payer due to their lack of being able to produce a separate radiology interpretation report. If the interpretation is included with the patient's assessment note then they consider it part of the assessment. So they may be denying these to see if you can appeal and produce a separate document from the assessment for the radiology interpretation.. Just a thought.
 
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ILuvRock~ Yes the clinic owns the equipment so that's not it but thanks for the help

mitchellde~ I will check into this to see if this may be the issue.

Thanks!!~Kim
 
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