re-read of films

RADCODER

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If our private facility is going to "re-read" and dictate a report of a CT or MRI films brought from another institution would we bill for the CPT code with modifiers 26 and 77 OR would we bill CPT 76140? I'm not sure what the difference would be.
 

jmcpolin

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I use the 76140 and bill the same price as an initial reading, I have seen some practices bill the actual code again with the 26 modifier.
 

aaron.lucas

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Sorry, but from looking at it, in my opinion 76140 doesn't seem to be appropriate, because it says specifically "consultation on X-RAY made elsewhere". Not sure what you would use. Maybe the CT or MRI code would be appropriate, but you would probably need the 77 to show that it's a different person. The only other thing I could think of would be an unlisted code, maybe 76499? Good luck getting paid for it though.
 

jmcpolin

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In the multi radiology practices that I have worked for specifically state use 76140 because the Radiologist has been asked for their opinion on the exam and are required to dictate a report. If the radiologist was doing an actual consultation there would need to be an E&M dictated as well. If the exam was re-read on a different date you would not use a 77 modifier.
 
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jmcpolin

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According to the Summer 1991 CPT Assistant, you should only report 76140
if a physician from another institution requests your physician's
opinion on a radiograph and you send that physician your interpretation.
You should not report 76140 if a physician within your practice or
hospital asks you to reread an x-ray that was primarily interpreted by
another physician within the same practice. Instead, report 76140 when
you interpret an imaging study that was primarily obtained and
interpreted by a physician from a different practice and with a
different provider number.

But Medicare will not pay for this CPT so you might just want to bill the reading.
 

aaron.lucas

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Not to be a PITA, but like you said that's for x-rays, so what would you use in the case of a CT or MRI? I'm actually curious now since it seems like you're experienced with this sort of thing.
 

aaron.lucas

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Ok...the code says "x-ray" though specifically, not "radiograph". Are you taking the radiograph from the CPT assistant that you listed above? I just remember being taught that if the procedure doesn't match the code, don't bill the code, and in this case to me it doesn't. But maybe this is a case where the guidelines in the book dont tell the whole story, which really peeves me, 'cause I feel that the book should have all the information you need to make a decision. But I suppose this is the way groups like the AMA and such make their money, by selling you two books when you should only need one. Sorry kinda went off on a tangent there...I suppose it makes sense now. Thanks Jen!
 

mhstrauss

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We have gone in circles in my clinic around this 76140 code. My opinion, based on all the info I've read: The original poster did not specify that the reread was being done at the request of another physician, therefore I'd be very cautious about using 76140--"CONSULTATION on Xray examination made elsewhere, written report".


As far as whether or not 76140 would be appropriate for MRI or CT as well as plain Xray, I have read before that yes, even though 76140 states "Xray", it would also be correct to use for MRI or CT. I will try to find the article and post link here.

Hope this helps! :)
 

aaron.lucas

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Thank you so much Meagan, that does make more sense now. And I apologize Jen for being such a pain, just got that golden rule stuck in my head and it's hard to override it! Maybe someone should recommend the code description be re-worded to include all radiographic tests? That might eliminate the confusion about what procedures are ok?
 
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