# Chest X-ray



## vnorman (Dec 6, 2013)

I seem to be getting conflicting information and was hoping for some help.  When billing for a chest x-ray do you use the physician in house when the x-ray is performed or the radiologist that reads the film?  OR can you bill it either way?    Any help would be greatly appreciated.

Thank you,
Valarie


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## polycoder (Dec 6, 2013)

The radiologist who reads the film


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## MarcusM (Dec 6, 2013)

Facility will bill for use of their machine. Radiologist bills for his interpretation.  Referring physician "might" bill for his interpretation as well, but will need to document thoroughly why it was necessary to re-read the X ray images, and what his impressions are versus what the radiologist indicated.


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## vnorman (Dec 9, 2013)

What if BOTH physicians work for the same group?


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## mhstrauss (Dec 10, 2013)

vnorman said:


> What if BOTH physicians work for the same group?



It would most likely be the radiologist.  The other physician (I'm going to assume that would be the ordering physician) might take a look at the film also, and mention it in an office note (and can get points for doing so under Amount/Complexity of Data Reviewed), but typically the radiologist creates the "official" report, and should get credit for that.

Just my $0.02


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## MarcusM (Dec 11, 2013)

http://www.nwhealth.edu/radiological-consultation-services/coding-recommendations/

Technical component (cost of film, processing, and equipment) - about 40% of the global fee
Professional component (time and expertise of the clinician) - 60% of the global fee
This example uses CPT code 72100, a two-view lumbar spine series.

1. If you take and read most or all of your films
You have 2 options a)  A global fee (i.e., 72100) which includes technical and professional components - OR b)  Separate technical and professional components (72100-TC or plus the professional component or reading fee 72100-26). Your report is the primary report. You can get a second opinion by using the 76140 code, when needed.

2. If you have all of your films read by a radiologist
Use 72100-TC for the technical component and 72100-26 for the professional component. You would then pay the radiologist from the 72100-26 component. The primary report will be produced by the radiologist.

3. If you have only some of your films read by a radiologist
This is an overread (second opinion) service. Since a global fee typically has already been billed, you should only use the overread code - 76140. The insurance company considers it double billing for the professional service if you use the -26 extension. Using the 76140 code assumes a primary report already exists.  

Note: Good patient care requires that all radiographs taken include a written interpretation. These reports can be done by the general practitioner or by a board-certified radiologist, sometimes by both.


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