Xray certification and billing questions...

deborahj

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I have a few questions and keep getting conflicting answers so I am asking the coding community to help me with this... Keep in mind that the NP has not taken any kind of x-ray course.

I work for a nurse practitioner owned family clinic in Tennessee. We recently dismissed our licensed x-ray technician. These are the following questions that I am hopeful someone can give me some clarification on. I am not willing to take the NP's word that I work for since it will be me who would be in trouble for wrong coding.

1. Is it required to have a licensed x-ray technician on staff or can the nurse practitioner take the x-rays themselves since they own the equipment that we are using?

2. Can the nurse practitioner bill for the professional and technical component of the x-ray if they read it themselves without having sent it for a read with a licensed radiologist?



Thank you,

debj
 

ggoode66

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Ownership of the machine has no bearing on whom can take the x-ray. You would have to check with your state department of health to see if individuals need to have some certification course. Some states still require an ARRT certified person, but many now allow a person to sit for a much shorter exam to receive a limited license. It will limit what exams the person can do, but a CXR will be on the list, if they have done it. As for billing the reading, I would check the report to see how the signature block is. Does it list the NP? or is it listing a MD? That again will fall under the state, but I've been an RT for 20 + years and I really would object if I read a report on myself or a family member that wasn't a Radiologist. The bigger issue is some carriers will not reimburse for radiological services unless it's an ACR approved facility/machine. Under the ACR, the NP can't take the xray and it needs to be an MD for the reading.
 
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We have recently noticed that a few payers do not reimburse the technical component of the xray when a mid-level orders. We own the xray machine, we have been instructed to bill a separate claim for the TC under the physician that is in the office for the date of service. What is your opinion?
 
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