Wiki Reading of ECHO

[Theresa Johnson]

I need help, please. I have just started working for a group of physicians who read various imaging tests. Here is my question. They don't have a physician in the group qualified to read ECHO's so they have contracted out the reading. The contracting group charges us (not the patient) for the reading at the current Medicare allowable rate. My doctors want to bill for the professional and technical component. Can I legally do this? If so, how do I account for the fact that the doctor reading the test is not part of our group? I have written to Medicare for information, but I'm afraid their answer is way over my head. Nothing I read from them indicates this can be done, yet nothing indicates it can't. Can anyone help me? I would so much appreciate it if you could.

Many thanks,

TJ

 

[vsmith]

This is easy to solve. You are going to bill global which mean bill the procedure without a modifier . Which you are telling the insuance that the technical and professional fee are included. The bill will be 93306 and that will take of this. Now you have another problem, you need to find out about your contracts with commercial. Does it include 93306 for your company if not .Than there are few steps you need to take. thanks vICKI CPC

 

[Theresa Johnson]

More questions

How do I report who performed the reading? I thought I was to use the reading provider's NPI when billing a test globally. Since the reading provider does not work for us, which of the five doctors do I choose to bill under?

 

[Amanedmaiston]

antimark up laws

I know this is an old post but you should read on the anti mark up laws. The OIG has several free videos on their website. You can also read on it in the Medicare manual which will give you some good answers. They also have very good examples in the manual.