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Second Opinion on X-Rays

  1. #1
    Capital Coders, Columbia, SC
    Question Second Opinion on X-Rays
    Medical Coding Books
    I recently joined a family practice / Urgent Care who sends out all of our X-Ray films to an outside radiologist for a second opinion. For the initial X-Ray, we bill it normally, both technical and professional components. For the second opinion, we are billing it under the same physician number, the day after the service date, with a modifier 26. These are paid by most carriers, denied by some. My question is: Is this procedure correct? Thank you in advance.

  2. #2
    Louisville, KY
    Really the reading radiologist should bill 76140, with no mods.

    I'm not sure if you folks are contracted with them or what . . . regardless, from the description, I'd advise that since you're sending a global charge initially, it'd be prudent to use the 76140 for all those second reads done elsewhere. (I'd also make sure those Rads re-reading were not submitting their own claims on the films, as that'd amount to double billing.)

    Good luck.

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