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ICD-9 Code for mole

  1. #1
    Default Correct Radiology Coding
    Medical Coding Books
    I am auditing a clinic who bills primarily radiology, however in their office (they own all their own equiptment) they have many specialists who refer from with in.
    Ok with that being said, my experience in coding radiology is very limited and although something doesn't "look" right to me I need answers other than just that it seems off?
    So here is what is being coded. All of the CPT codes I'm about to list are for the same physician and the place of service is 11.
    This is what they are billing.
    My question is this; is it ok to bill the technical componet with a place of service 11? I have tried to check throughout Trailblazer website to determine this on my own but was unable to find a clearly defined answer.
    Or if it's "ok" then please let me know as well. Thank you in advance

  2. #2
    Is someone else reading the films and billing the 26 portion?

  3. #3
    Default Radiology
    No, that is what I don't get as well. To me they should be billing just the code w/out a modifier. If the referring is under the same group NPI, they own the equiptment, etc?

  4. #4
    Default Sue Haydysch
    Medicare may require that the TC/PC portion be split into separate claims. Therefore the physician codes with the 26 is on one claim form and the facility billing with the TC codes be on another form.

  5. #5
    If the doctor (clinic) is reading his own films and owns the equipment, then no modifier (TC/26) is needed.

    I work at an ortho office (place of service is 11) we own and read

  6. #6
    Default thanks
    thank you very much

  7. #7
    Default ?
    If in the fact that they are doing the scan for an outside physician who is billing the read seperately would they still use the same POS, since they are just billing facility charges?
    I don't think this is the case but I would like to know all the same?

  8. #8
    Overland Park, KS
    Default ICD-9 Code for mole
    I need help please to find the ICD-9-CM code for "mole changes." Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  9. #9
    782.9 perhaps?

  10. #10
    You need to be a little more specific has the mole become cancerous?

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