Question 1. If imaging is done of the kidneys and bladder the most appropriate code is 76770. I would not code each of these exams seperatly unless they are performed at seperate patient encounters and dictated as seperate reports.
Question 2. We have encountered problems getting paid for pre-MRI orbit screening xrays as well. We require the referring physician to order the xray (doesn't matter if it is on the same order as the mri or not) and dictate it seperatly. Most payers bundle this exam into the MRI and we don't expect to get paid for most of them, and just write them off after the denial.
Question 3. When doctors read these spot fluoro films for procedures performed in the O.R. by other doctors the general rule of thumb is you bill the xray code appropriate. For a spot fluoro of the chest done during a central venous catheter placement you would bill a one view CXR 71010. The other recommendation for these exams is to bill the normal code for the imaging portion the the exam but with a 52 modifier to indicate a reduced service because your physician was not in the O.R. at the time of the exam. (e.g. 74220-2652 if billing the the radiologists) Make sure the Rads are actually dictating diagnostic findings for these exams as well! Just saying that flouro was utilized for (enter exam here) will not fly.
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