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76140 Review of xrays performed elsewhere

  1. #1
    Default 76140 Review of xrays performed elsewhere
    Exam Training Packages
    Is anyone using CPT 76140 - "Consultation on x-ray exam made elsewhere, written report" when an orthopaedic surgeon is reviewing the films brought in by a patient? If so, are you getting paid for it? I cannot find any literature on if this is an acceptable code for the surgeon or be used by a radiologist only. JS

  2. #2
    North Carolina
    Per Cpt Assistant...

    CPT code 76140 Consultation on x-ray examination made elsewhere, written report is intended to be used when, for example, Doctor "A" from Sunnydale Hospital sends a radiograph taken at Sunnydale Hospital to Doctor "B" at Goodhope Hospital. Doctor "A" asks Doctor "B" to offer his opinion on the radiograph. Doctor "B" writes a formal report on his interpretation of the radiograph and sends a copy of this report to Doctor "A."

    This code is not intended to be used by physicians within the same institution to reread radiographs taken at that institution. Levels of Service (limited, intermediate, extended, comprehensive) include the "evaluation of appropriate diagnostic tests" which may necessitate the attending physician to personally review the radiographs taken on his patient.

    I had some ortho physicians that wanted to use this CPT code; however, the physician can not use this code when the patient simply brings in the xray and the physician reviews/interprets the films. This service follows the same ideology as a consult service. Consult= 3 R's=Request opinion, render opinion, report opinion. If your providers are providing this service at the request of another provider and the criteria is met, you should be reimbursed. However, be prepared to appeal with documentation...and don't forget your modifier 26.

  3. #3
    Duluth, Minnesota
    Hey Rebecca... do you have a source for that... ". This service follows the same ideology as a consult service. Consult= 3 R's=Request opinion, render opinion, report opinion"? I would GREATLY appreciate it!! I have a provider that wants to charge xray consult every time he reviews an xray - NOT only that, but rather than even use the xray consult code - he wants us to us the xray code itself, with a .26 and .77 modifier appended to it! all he is doing is simply looking at an xray that was already done, and read by another. He isn't "reading it" that's been done already, he's basically looking at it himself and reading what the finders were..

    Last edited by dmaec; 08-31-2009 at 12:06 PM.
    Donna, CPC, CPC-H

  4. #4
    Default CPT ASST Oct 1997
    Using Code 76140

    76140Consultation on x-ray examination made elsewhere, written report

    You would use this code when a physician's opinion or advice regarding a specific film is requested by another physician and upon examination of the film, the consulting physician renders his or her consultation (ie, or his/her opinion or advice) to the requesting physician in the form of a written report.

    If a patient presents to an office for a new patient visit and brings to the physician his or her medical records, including x-rays, you should not report code 76140. Although the x-rays may have been taken elsewhere, the physician does not perform a consultation as intended by code 76140. Rather, the review or re-read of the x-rays would be considered part of the face-to-face E/M service provided to the patient. Again, the E/M codes include work done before, during, or after the E/M visit. Review of x-rays is part of the E/M service. Remember, 76140 represents a consultation, in which a physician only renders an opinion or gives advice regarding the film in the form of a written report. In general, when reporting 76140, the physician is not concurrently providing an E/M face-to-face service to the patient.

    © 2005 American Medical Association
    Mary, CPC, CANPC, COSC

  5. #5
    Duluth, Minnesota
    Thanks Mary ... I agree ...however, the other coder for this provider does not. so of course, I'm trying to find something concrete...that she can read that states the meaning, more specifically on the 76140 cpt code.
    I agree with you and Rebecca...and it seems clear to me,... but she disagrees. coders and our opinions and interpretations hey!

    thanks again!!
    Donna, CPC, CPC-H

  6. Default
    Can we use modifier 26 with this? Encoder is not showing 26 in the modifier list.

  7. #7
    North Carolina

    PM you...

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