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X-ray done in office within 20 day global..patient in SNF

2

2believe

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Homosassa, FL
For the first 20 days of a global surgery. (eg Hip replacement) patient comes into office and an x-ray is done. Patient resides in SNF. The physician reads and discusses results with patient. The x-ray is billed to Medicare then denied stating to bill to SNF. Then SNF denies claim stating to add a 26 modifier. They did not perform or read the x-ray, nor do they have a copy of it! I am confused! Has there been a change when billing an x-ray ? Do we add a 26 when they did nothing to deserve payment?
 
When a patient is in a Medicare covered SNF stay, the SNF is responsible for the technical components of most services provided to the patient during the stay under Medicare’s consolidated billing rules. The physician can bill Medicare for the interpretation (modifier 26) but the technical component is the responsibility of the SNF and they are required to reimburse your office for that part if Medicare so indicates.

Diagnostic tests aren’t part of the global surgical package, so it makes no difference that this is in a global period.
 
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