Wiki physician billing -26modifier

[donsgirl1015]

please weigh in on this issue at my office ~

scenario: patient falls, hurts wrist, goes to PCP or Urgent Care, has xrays taken. yes, it's broken, take this xray to an orthopedic specialist. this patient then comes to my office with cd of xray(s) with them. our provider pops the cd in the computer & views images.

now - I get a billing ticket with 99213 & 73100-26

is this appropriate? provider says since he is looking at the image, not reading a report it is "interpretation"


thanks for your help....
melissa

 

[ccollison]

Just viewing the CD does not qualify for an interpretation. He would get credit on the E/M for personally reviewing the image. But an interpretation requires more work than that, usually a separate report with an order, medical necessity and interpretation.

Cindy, CPMA,