Wiki testing - ordered by one Dr, interpreted by another

[tgutierrez]

Need some help with how to do this.

We have two Physician's in our practice. If one physician orders testing but the other interprets the tests and discussing them with the patient on a separate day, how do I bill these and under which physician?

Thanks for the help.

 

[uscophthal]

We ran into a bit of a conundrum with this issue and had to deal with denied claims. (It really depends on the payer because some don't have a TC and 26 on their fee schedules.) What we did in the end was billed according to supervision rules. If the test did not require the physician to be present in the office suite and immediately available, we billed the code w/o any modifier under the doctor who performed the written interpretation. However, if the testing required physician presence, ie 92235 (fluroescein angiogram- b/c of needle stick and dye) and the test was done when Dr. A was in clinic, but Dr. B interepreted the test, we reported 92235-TC Dr. A and 92235-26 Dr. B.

Hope this helps.