AAPC - Back to school
Results 1 to 4 of 4

Thread: Radiology Billing

  1. #1

    Default Radiology Billing

    AAPC: Back to School
    Our group has been in negotiations with a radiologist for coverage and over reads. He currently works for other places as well and I have found that the other clinics do not bill using the radiologist as the rendering for any of the radiology services. They bill these services (globally) under the ordering physician. I did not think that was the correct method for billing, however my medical director now wants to pursue this method of billing if possible. Can anyone tell me if this is an allowable way of billing for radiology services?

    Valarie, CPC

  2. #2


    Hay Valrie, we are having this same issue. I have written to Medicare under the freedom of information act and nothing in their regulations spell out how to bill for this situation. I agree with you, since the rendering provider is not part of your group you cannot bill using his NPI. The ordering provider did not provide the service but is being charged by the rendering physician for the reading. It is a catch 22 situation.

    I will be very interested in hearing how others handle this. So far, we are not billing globally for services.


  3. #3



    Please keep me updated with the progress of this if you dont mind. I will be very interested in the out come. I dont want to start billing under the referring as I just dont feel it is the proper way to bill. Thanks so much!


  4. #4
    Join Date
    Apr 2007
    Alexandria, LA


    This falls under the "anti-mark-up" rules. Look at Chapter 1 of the CMS Claims Processing Manual http://www.cms.gov/manuals/downloads/clm104c01.pdf section 30.3.7.

Similar Threads

  1. Radiology billing
    By kristen.mangas@yahoo.com in forum Billing/Reimbursement
    Replies: 1
    Last Post: 04-16-2014, 09:46 AM
  2. Radiology Billing
    By BABZ73 in forum Auditing General Discussion
    Replies: 2
    Last Post: 01-24-2011, 06:47 PM
  3. Radiology billing
    By CRICKLE in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-24-2010, 03:55 PM
  4. Radiology Billing
    By rgreen52@comcast.net in forum Interventional Radiology
    Replies: 2
    Last Post: 02-02-2010, 08:22 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.