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supervision and interpretation

Colliemom

Expert
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400
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New Haven, CT
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(new to radiology coding) When coding for radiology I read the following: "When a procedure is performed by two physicians, the radiologic portion of the procedure is designated as radiological supervision and interpretation. When a physician performs both the procedure and provides the imagining supervision and interpretation, a combination of procedure codes outside the 70000 series and imaging supervision and interpretation codes are used."

In layman's terms what does this mean?
 
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mbort

True Blue
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2,338
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ENGLEWOOD/DENVER
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the physician reading the x-ray will use the modifier 26
the facility that owns the equipment will use the TC modifier

if the physician is reading and owns the x-ray equipment--no modifier is necessary.
 

Colliemom

Expert
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New Haven, CT
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Thank you, I knew about the use of the 26/TC modifiers for radiology codes, but the way that read I thought it was referring to using other codes outside of the 70000 codes. I wasn't sure how that would work.
 

mbort

True Blue
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ENGLEWOOD/DENVER
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I interpret it as meaning whatever the procedure is, whether is a pain injection, or fracture treatment etc that require the use of x-ray/fluoro/ultrasound type equipment.
 

kamala

Contributor
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HI ,


Most of the Radiology Dr.'s perform Invasive as well as Assiting in the invasive procedures (where more intervention is needed ) .

The Radiologists are not credientialed to perform OPEN procedures , they can deal with anything that is done is percutaneous or else should guide a surgeon technically with the guidance expertise he has like US , CT , MRI , flouroscopy etc

Hence , if a Radiologist bills a procedure , which is done solemly by him , then he has to bill both the Surgery code and the S&I code (70000 series ).

Where as , if he guides a surgeon of any speciality then , he has to bill for the S&I alone with the -52 modifier , since the surgeon would have billed for his procedure ( surgery CPT ).

Current Billing rule , in more invasive IVR procedures , the radiologist should not bill , separately , he would get paid with the primary procedure billed by the surgeon and in turn the surgeon would pay the Rad dr.

So , we have to be much careful with the dictation , to ensure that our Dr. ie Radiologist having the dictation of surgery signed with informed consent ..

I hope this would help you .

Regards,
Kamala
 

ciphermed

Guru
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194
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I interpret the combination coding to mean the S&I in addition to the surgical component (code outside of 70000 range, ie Biopsies, PTA's , Stent Placements etc.)
 
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