Wiki Radiology DOS

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afryberger

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I know I asked this before, i don't think I was as clear as to what i needed. I understand I'm going to have two DOS. What i don't understand is on the actual report from the provider, which are we to use. This is what we were told:" 11. Date of service should be considered from Signed/drafted date which is given at the bottom of the report and all the modifier should be append on the basis of Signed/drafted date. Don’t take exam date as date of service."I have never heard of this. Films have there own DOS. The report is the interpretation and report, so it would be the exam date. Sign can sign off whenever, after it goes through being transcribed, that doesn't make it the DOS. I feel crazy.
 
Not sure where you got that quote, but it is wrong. Say I have an xray on Oct 31, and the doctor doesn't sign the report until Nov 2. And say that my insurance changed on Nov 1. Who is going to pay the Nov 2 claim?

The exam date IS the date of service.
 
If you are coding for films, CMS guidance is that if the professional component is billed separately from the technical, the date of service should be the date that the interpretation was completed - see the section on page 1 for radiology services here:


They went back and forth on the policy for a long time (it was originally published in 2017 but then rescinded) before finally coming down on the side of using the date of the interpretation in 2019. I have never understood why they made this decision and have always felt that this was not the right move, for the reason Sharon cites above, and because since it creates a lot of confusion about when and where the service actually took place and makes it pretty much impossible for payers to tie the professional component back to the technical for the same service for purposes of applying benefits and avoiding duplicate payments, but logical or not, this is the guidance.

Here's an AAPC article on this:
 
I thought I would mention I posted an answer to a similar question where I think I said the opposite thing as here.

There are times when I think guidance is clearly wrong. And I think it is clearly wrong in this case, for the reasons I mentioned above. I would say if you do interpretation of images taken near the end of the month, particularly near the end of December, and you follow the guidance, you're going to have issues. I think I would probably dig in my heels and keep using the exam date as the date of service. My report (my provider's report) would have this:

Imaging Date: XX/XX/XXXX
Date of Interpretation: XX/XX/XXXX
 
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