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Wiki Radiology

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wpienaar

Networker
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Location
Lehi, Utah
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If a patient comes into our office with an xray film, our provider views the film to determine finding and/or diagnosis, is it appropriate for our provider to bill the professional component of the xray code?
The xray will also be reviewed by a "radiologist" who will also submit the professional charge. Do payers pay both providers? Is it correct for both providers to submit that charge? Any information will be appreciated.:)
 
If your provider is licensed to interpret radiology and is credentialed with insurance companies, he may bill if he is interpreting it and dictating the report.
 
How to bill

I think if the Doctor reviewed the films and had a diag. he should billed as part of his E/M Service. According to the MDM he can get points for reviewing the films.
 
radiology

we bill radiology services with global charge. we had a case that the insurance carrier didn't pay us on professional component of Xray because ordering pysician billed professional component and got payment.
 
Code 76140 is available for a second read/opinion if a formal report is issued but if it was part of an office visit, I would think it would be part of the E/M service.
 
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