X-rays during ORIF

jfahan

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We have a discussion going on regarding whether or not we can bill for x-rays taken during a surgery to repair a fracture. We currently bill for this being done at our ASC for the physicians, but are not doing this for surgeris done at the Hospital. Does anyone have any information or input on this subject. Is there a website that provides specific information regarding this? Any help is greatly appreciated!!! :)
 

mbort

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I'm assuming you are using 76000-26? Its okay to bill it for procedures performed in an ASC (as long as there is a report to support and no body else is reading the films) just be sure to watch the cci edits for those procedures that bundle it. I have had a heck of a time getting carriers to pay it so I would be interested in finding out how many practices are actually getting paid for the 76000-26?

Mary, CPC,COSC
 

jfahan

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Can we also bill those same x-rays during the surgery in a Hospital setting? I have been getting mixed answers. And we are using 73XXX codes
 
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mbort

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I would not do it in a hospital setting as they always have a radiologist read them. When patients are having surgery at an ASC, the x-rays that are being taken are not done on a true stand alone x-ray machine, they are usually done via portable fluoro/c-arm so you would need to use those codes instead of the 73xxx series (unless your ASC is different than most).

hope this helps
Mary, CPC,COSC
 

mksmith713

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I would code rads done in an ASC the same as I would in the office....that is...if your office is sperate from the hospital.
My guess is that the hospital itself is billing the films done there.
They provide the equipment, techs and radiologist to do the interpretaion and OFFICIAL radiology report so IMHO, you can't code that.
That's the hospitals $$$$.
 

mbort

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unfortunately you can not bill them the same as you would in the office. You have two components so if you are doing them at an ASC, unless your doc owns the equipment, you can not claim that component, you can only capture the professional component. Also as mentioned in my previous post, in the office setting you have "x-ray" equipment. In most ASC's they use Fluoro or c-arm, the codes are totally different than regular x-ray equipment.

So..what I am really trying to say is....PLEASE do not bill them the same as you do in the office, its incorrect.

(I code for both private practice ortho's and ASC's, so I have experience with coding both scenarios)

Mary,CPC,COSC
 
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