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x-ray and Fluoroscopy

  1. #1
    Location
    Scranton, PA
    Posts
    32
    Default x-ray and Fluoroscopy
    Medical Coding Books
    If the patient has both a 2 view xray of the wrist (73100) and a fluoroscopy of the wrist(76000) at the same visit, can you bill for both. Since the x-ray is looking at the bone and fluorscopy is looking at tissue and deeper structure my feeling is they both should be able to get billed. 76000 also has a Q status indicator with Medicare OPPS.

  2. #2
    Location
    Louisville, KY
    Posts
    1,101
    Default
    For what purpose was the fluoro done?

    What the fluoro used in conjunction with a fixation or other surgical service?

    I presume the X-ray was either for diagnostic or follow-up purposes...but can't really say whether both would be appropriate until the situation is clearer.

  3. #3
    Location
    Modesto, CA; Central Valley Chapter
    Posts
    225
    Default
    I hate to tack on to this but....from your response Kevin, if flouro is done in a surgical setting to identify the fracture the flouro would be included...is this correct?

    thanks
    Tina

  4. #4
    Default
    There are no bundling edits for the two codes billed together. I personally would bill both and be aware that depending on the payer you might get a denial. I would try to get paid, rather than not even consider billing both.

  5. #5
    Default
    There are edits that state:

    If formal contrast xrays were done and included as part of the major procedure to produce films with written interpertation and report, then flouro is already included and can not be reported separately.
    resource: 2008 ortho coding companion(ingenix)

    Basically, if xrays were done, the fluro would have to be a distinct and separate procedure (mod 59). I have gotten denials, I refer back to the op note and if it does not qualify for a mod 59 it should not be billed.

    I can fax edits if you would like.

    Hope it helps.
    Thanks,
    Profmedgirl

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