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Second opinion...

  1. #1
    Default Second opinion...
    Medical Coding Books
    I work for radiologist's and I was just wondering if anyone knows if we can bill insurance companies if we generate a report through our office on exams performed at another office or institution. These exams would be brought to us by referring doctors asking for a second opionion.
    And if we can what CPT code should we be using?
    Thank you so much!

  2. #2
    Louisville, KY
    76140: Consultation on X-ray examination made elsewhere, written report.

    This is professional component only, in that no TC charges are accrued for the rendering of this service (mod -26 does not apply). There must exist some type of written report to validate the charge. Generally, I have always gone with the ACR requirements of a report and left it at that. In other words, this is no different than any other radiological examination, the requesting physician should order the consultation and the written report stands as communication back to him.

    Hope that makes sense.

    Kevin B. Shields, CPC, CCP, CCS-P, CPC-P, RCC, ACP

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