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Thread: Comparison X-rays

  1. #1

    Default Comparison X-rays

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    I have a pressing questions for all ortho coders....

    If a provider takes an x-ray of the patient's left foot and then takes an x-ray of the patient's right foot for comparison reasons (no other reason just a comparison), can you report the comparison x-ray?

    I read in an orthropedic manual from Ingenix that comparison x-rays that are done in the absence of medical necessity (no signs/symptoms) are considered screening by Medicare and are not payable. Does anyone know this to be true and can you point me to a specific guidance from CMS that states this?

    Also, would you use modifier 50 for the comparison x-rays, or just LT, RT?

    Thoughts?
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2
    Join Date
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    Default

    Dawson:

    Comparison reviews are not billable--they lack medical necessity. Truthfully, I cannot locate CMS guidance, but check out the ACR website for further guidance.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  3. #3

    Default

    Kevin:

    This is what I thought as well, but need some reassurance. Thanks so much as always!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

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