Results 1 to 4 of 4

Radiology CPT 76140

  1. Default Radiology CPT 76140
    Medical Coding Books
    Can this code be appropriately billed in an orthopedists office, if a patient is sent to us for a consultation and brings a x-ray without interpretation?
    Thank you,
    Melanie Estrella

  2. #2
    Location
    Baton Rouge
    Posts
    1,241
    Default
    Quote Originally Posted by MELANIEESTRELLA View Post
    Can this code be appropriately billed in an orthopedists office, if a patient is sent to us for a consultation and brings a x-ray without interpretation?
    Thank you,
    Melanie Estrella
    We've gone in circles in my clinic about 76140. After much reading through Medicare, ACR, and various other resources, my opinion is that looking at an Xray is part of of the E/M visit. He can do his own interp and get 2 points in the "amount of data reviewed" part of the E/M service. But should not bill separately for reviewing imaging.

    Just my $0.02!!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  3. Question Additional Question
    Scenario: Patient is seen on an emergent basis in Mexico and has ultrasounds performed. The patient returns to the US and brings ultrasound images back with him. The patient gives the ultrasound images to his PCP. The PCP then gives the radiologist the images, and the radiologist writes a report. Thus, the radiologist is not billing for the appropriate E&M...do we...
    A) Bill Medicare with the 76140 which they do not cover and will deny, or
    B) Bill with the ultrasound CPT code with the 26 mod, as the radiologist did not use his equipment, just used his professional opinion to interpret the ultrasound.

    Thoughts? I am also in need of a Medicare policy regarding this and haven't been able to find one.

  4. #4
    Default
    Quote Originally Posted by JulesUtah View Post
    Scenario: Patient is seen on an emergent basis in Mexico and has ultrasounds performed. The patient returns to the US and brings ultrasound images back with him. The patient gives the ultrasound images to his PCP. The PCP then gives the radiologist the images, and the radiologist writes a report. Thus, the radiologist is not billing for the appropriate E&M...do we...
    A) Bill Medicare with the 76140 which they do not cover and will deny, or
    B) Bill with the ultrasound CPT code with the 26 mod, as the radiologist did not use his equipment, just used his professional opinion to interpret the ultrasound.

    Thoughts? I am also in need of a Medicare policy regarding this and haven't been able to find one.
    This particular scenario would be excluded from Medicare coverage because a part of the service was performed outside of the U.S. (See Chapter 16 of the Benefit Policy Manual).

    If the ultrasound had been done in the U.S., the radiologist could bill for the interpretation, or the provider could bill for it if they purchased the service from the radiologist. lled another provider. This is discussed in a little more detail in Chapter 13 of the Medicare Claims Processing Manual, see sections 20 - Payment Conditions for Radiology Services, and section 100 - Interpretation of Diagnostic Tests: https://www.cms.gov/Regulations-and-.../clm104c13.pdf
    Thomas Field, CPC, CEMC

Similar Threads

  1. CPT code 76140 Consultation on X-ray examination made elsewhere,writen report
    By dyates in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 03-16-2015, 12:16 PM
  2. CPT 76140 Consultation on x-ray
    By tmorehart in forum Interventional Radiology
    Replies: 0
    Last Post: 04-11-2013, 12:52 PM
  3. Radiology Consult - 76140
    By scorrado in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 09-14-2012, 06:04 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.