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In-house X-ray

  1. #1
    Default In-house X-ray
    Medical Coding Books
    We recently had to send Medicare (First Coast) medical records on a paient that had in house x-rays.

    Doctor dictates "X-Ray-examination of the lumbosacral spine, six views, AP, lateral obliques, flexion and extension views, reveal scoliosis, severe diminution of the disk height, facet arthopathy"

    Medicare comes back denying the claim stating there was no procedure report of the x-ray.

    In the body of the the dictation the doctor clearly states the report and it is also at the end of the dictation on its own.

    Any suggestions would be wonderful!

    Thank you

  2. #2
    Salt Lake City
    did he do a separate report for the xray or add it into the E&M visit note?
    Jenifer McPolin CPC, CPMA, RCC

  3. #3
    It is within the body of the E&M as well as a seperate report after his dication was complete on the same page. Do you think it should be on a completely seperate page?

  4. #4
    Salt Lake City
    yes I just had to research the same question for urgent care check out these guidelines
    Jenifer McPolin CPC, CPMA, RCC

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