Wiki UC Radiology coding/billing

[Freitag17]

Hi!

Working in an urgent care setting and we are shuffling who gets credit for what when coding/billing radiology services with proper modifier.

Provider A orders an Xray and documents a Wet read.
Provider B comes in and Provider A has left for the day or left for vacation, so Provider B documents the interpretation.

Are you billing for both providers? With being an urgent care facility, inhouse Rad, would a TC/26 modifier even be added to these claims?

 

[CBLENNIE]

If the technical and professional components are all being done in house at your UC, you would bill the global CPT code for the x-ray and not use either TC or 26 on the claim submitted to the payer.

Provider B should get the credit for the professional services related to the x-ray because they did the formal interpretation. You may need to submit 2 separate claims to the payer to submit the charges for provider A's services provided to the patient during the visit, not including the charges related to the x-ray. Then another claim would be submitted for provider B with the global charge for the x-ray for the DOS because they are the one signing the radiology report.

If you are asking about who gets credit for what in terms of your internal systems for crediting providers for the revenue they generate, that is a whole different situation and that would be an internal policy/procedure for your practice.