Reimbursement for interventional radilolgy

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What code do I use for a Radiologist that works for a hospital and assisted with the procedure 66490 Injection diagnostic or therapeutic agent paravertebral facet joint. He completed the image guidance part of the procedure. Image guidance is included in the procedure. what code can I use for the professional component of the procedure for the Radiologist?
 

thomas7331

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What code do I use for a Radiologist that works for a hospital and assisted with the procedure 66490 Injection diagnostic or therapeutic agent paravertebral facet joint. He completed the image guidance part of the procedure. Image guidance is included in the procedure. what code can I use for the professional component of the procedure for the Radiologist?
I'm not sure if there's any official guidance on this sort of thing, but what I've done in this situation, if the medical necessity of both providers is documented in the record, has been to code the surgeon's work with the main code with a 52 modifier to show that that provider did not perform the full service, and then code the radiologist's work with the imaging guidance code with an XP modifier to show that this portion was performed by a different provider and specialty and is therefore not a bundled service. If there isn't a medically necessary reason documented for the second provider, though, then I'd think that this might be more appropriately billed just by the one provider with the other's work as a courtesy. That might be something to discuss with the providers.

I'd be interested to know if anyone else has any thoughts on this.
 
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