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MRIs, TCs, and 26s

  1. Question MRIs, TCs, and 26s
    Medical Coding Books
    Hi everyone, I sure would appreciate some input here...

    Our orthopedic clinic owns our MRI equipment. We bill for the technical component only, and send out the MRIs to be read by radiology.

    Here is the dilemma.... After the radiologist over-read, our physican decides that he does not agree with the radiology report at all, and dictates his own report after reviewing the MRI. He would like to know, can he now bill for the professional component of the MRI as well?

    Any thoughts are most appreciated...

  2. Default
    My understanding is that yes, you can bill for the 26 portion as long as you have a copy of the films, either digital or a "hard" copy. When one of our physicians does an injection under flouro in the hospital, we bill the 26 since he brings a copy of the films back to the office and dictates a report.

    Hope this answers your question.

  3. Default
    My office has our own MRI machine too. We bill the full amount to all insurances except Medicare. We bill the TC on those claims unless the doctor decides to read it as well then we don't put any modifiers on the claim.

    i.e. 73718-TC $995 (for medicare only) all others are billed $1495 with just the RT/LT

    Hope this helps. (Both the radiologist and my Doctors read the MRI's)

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