I code for a Radiology Department for over 2 years now. Like you we are multi-specialty. The radiologist can put his recommendations on the report for further treatment or for a follow up exam, but not actually refer a patient to a specialist.
The radiologist reads the report for the ordering doctors, so that ordering doctor should get the report and handle the results with the patient. If the patient need to go to a specialist that should come from the doctor who ordered the x-ray and not the radiologist who read it.
So in the example you gave a PCP finds a lump and sends her for a diagnostic mammogram. The radiologist confirms the presence of the abnormality and recommends a surgical consult. That report should go back to the PCP and he should discuss this with the patient and the PCP should refer the patient to a surgeon.
Good luck!!! Hope this helped!!
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