574coding

Guru
Messages
132
Location
Los Osos, California
Best answers
0
Hello,
I am having a hard time with this code and a provider. They feel they can bill for it. I do not. They want me to find the "professional fee".

The way I see it is the provider orders the test, it adds to the MDM on that visit, will bump up the E&M level and the provider does not get reimbursed for "reading" the test results.
I do not think they have a "professional componment" to this type of a test.

When this type of a test is run, the patient would receive the billing from the "lab" its not like a CXR or ECHO that you need to interpert the results. Right?

I was wondering if anyone has infomation to support either way? If you feel they can bill a professional fee, how can you figure out the amounts? I did not see the code on the Medicare Part B fee schedule. I think it only has a fee on the clinical fee schedule.
Thank you for your help with this!
 
Top