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Clinical Example: Patient is in ER with confirmed fracture by radiology department. The ER MD or orthopedic MD performs a reduction procedure and orders another xray to confirm alignment. The hospital radiologist interprets the comparative xray.
The NCCI Manual (Chapter 9, Edit #3) it states the following: “3. When a comparative imaging study is performed to assess potential complications or completeness of a procedure (e.g., post-reduction, post-intubation, post-catheter placement, etc.), the professional component of the CPT code for the post-procedure imaging study is not separately payable and should not be reported. The technical component of the CPT code for the post-procedure imaging study may be reported.”
I’d like to confirm if this guideline prevents a radiologist from billing the professional component for the comparative imaging study (post-reduction) when they are not the provider that performed the reduction procedure....or does it apply to same provider/same specialty that performed the procedure only?
The NCCI Manual (Chapter 9, Edit #3) it states the following: “3. When a comparative imaging study is performed to assess potential complications or completeness of a procedure (e.g., post-reduction, post-intubation, post-catheter placement, etc.), the professional component of the CPT code for the post-procedure imaging study is not separately payable and should not be reported. The technical component of the CPT code for the post-procedure imaging study may be reported.”
I’d like to confirm if this guideline prevents a radiologist from billing the professional component for the comparative imaging study (post-reduction) when they are not the provider that performed the reduction procedure....or does it apply to same provider/same specialty that performed the procedure only?