I work for an Internal Medicine practice. We perform ultrasounds here in the office, but a Cardiologist reads and interprets the reports. We do not have a problem getting paid for the technical component, however....the Cardiologist is being told his claims are being denied by his billing dept. I'm not sure how they are billing the claims except they know to append the 26 modifier. Can anyone give me any suggestions as to what they are possibly doing wrong? I just want to help them out. Is the Cardiologist's billing dept. supposed to use the dos the u/s was performed here in this office or the date the report was dictated? Is the dx code used to order the procedure the same dx code used to bill for the interpretation and report? or should they be using the dx from the interpretation? Any advice would be helpful!
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