Wiki ReReading of MRI

[LBJ]

I'm at odds with a provider who wants to bill for the "re-reading" of MRIs. He states that there is a special code to use for this service. Example: a pt comes to him for a consult and brings MRI's with him/her and during consult the provider reviews MRI and reports. My thought is that this service is included in his consultation and may affect the level of service he can bill for, but he can not bill for the review of MRI's since they have already been read and billed for by another provider. I'm not finding any "special" code to specify this type of service either. Thoughts?????????

 

[kevbshields]

Included in the medical decision making component of the E/M service; therefore, not separately reportable by most accounts.

 

[LBJ]

What do you mean by "most accounts"? I am trying to find something in writing to back up these opinions. Any suggestions of where to find the black and white proof of this rule?

 

[kevbshields]

Look at the part of an E/M score/audit sheet where credit is given in the Data section for "visualizing image", etc.

 

[mbort]

The code that they are referring to is 76140. I only know this because I just went through a knock down/drag out with my ortho guys. When I came to their practice they were billing it all the time. NOT ANY MORE!! I do not have the documentation saved but I was able to do the research and provide them with the "black and white" to prove it to them. If I come across it again I will post it for you.