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Xrays in office

  1. #1
    Smile Xrays in office
    Medical Coding Books
    Does anybody have any resources on the specific documentation required for an orthopedic surgeon to do xrays in the office?

    Thanks
    Christy

  2. Default
    Hello,
    the ortho surgeon I work for does Xrays in the office as well and he just dictates a separate paragraph in the office visit note regarding the interpretation of the xrays and what was done.

  3. #3
    Location
    Columbia, MO
    Posts
    12,844
    Default
    The interpretation is to be on a separate radiology interpretation report. This is stated per the AMA and I believe is in the CPT book in the front of the radiology section. It cannot be a paragraph in the progress note. I was involved in an audit of an ortho practice where this was a big issue.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    Medicare Part B Policy Palmetto GBA MAC - J1

    Effective Date
    02/26/2009

    Publish Date
    June 2008

    States Affected
    GU HI NV CA

    Policy Number
    J1B-08-0070-L

    Subject
    Radiologic Examination, Chest



    "Each payable interpretation must include a complete, written report similar to one that is prepared by a specialist in the field. The content of the written report must address the relevant clinical issues, available comparative data, and test findings. The format of the report must be separately identifiable. It may be included under a separate heading within the clinical record."
    Mary, CPC, CANPC, COSC

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