# Radiology-26 referral?



## FDRAPER (May 13, 2010)

I bill for a hospital based,reading radiologist. Medicare denied a cxr, saying it's because the referring physician was a chiropractor. I was told to resubmit the charge & put my Dr. as the referring. My Dr. happened to be out during that timeframe & I was billing with a -Q6. How can he be the referring Dr. when he wasn't there & can a reading rad self-refer unless it is to order a more thorough test because they see a problem?


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## mitchellde (May 14, 2010)

Why did you use the Q6 modifier?


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## FDRAPER (May 14, 2010)

*Radiology-26*

Because it was a locum tenum situation- my Dr. was out & a virtual rad was filling. I billed all MCR claims(with -Q6) & the hospital billed for all other insurances.


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## thegranddiva1 (May 14, 2010)

Why not use the attending physician or the patients PCP?


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## FDRAPER (May 14, 2010)

*Chiro referral for cxr*

It was ordered as outpt, so there was no attending Dr. Also, it was ordered by the pt's chiropractor- I don't see how I can put the PCP on the charge if the PCP was not involved.


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## mitchellde (May 14, 2010)

you may need to get into this insurance particulars regarding chiropractors.  Many ins plans do not cover services performed or ordered by chiropractors.


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## RebeccaWoodward* (May 14, 2010)

mitchellde said:


> you may need to get into this insurance particulars regarding chiropractors.  Many ins plans do not cover services performed or ordered by chiropractors.



I agree-Medicare does not allow Chiro's to order xrays...

http://www.cms.gov/MLNMattersArticles/downloads/SE0416.pdf


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## FDRAPER (May 14, 2010)

*Chiro referral for xray*

I agree with the chiro situation, but I really need to find out what MCR regs say about making my Dr.(reading rad, who was out of the country at the time) the referring Dr.


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## mitchellde (May 15, 2010)

I say no you cannot do this as he was not the referring doctor.  If this payer does not allow for a chirpractor to referr for xrays then you cannot bill this service.


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## FDRAPER (May 15, 2010)

*Chiro referral*

I agree. Do you know where I could find specific policy on this?


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