Neurology & Pain Management Coding Alert

Question: If a neurologist orders a radiological test such as a CT scan or an MRI, and he or she also looks at the films in addition to the radiologist, can the neurologist be reimbursed for reading the films?

Iowa Subscriber

 
Answer: If a radiologist has already interpreted a computerized tomography (CT) scan or magnetic resonance imaging (MRI), the neurologists review of the report is included in the decision-making portion of any E/M service provided. If the neurologist felt that there was a significant discrepancy between his or her findings and those provided by the radiologist in the original report and he or she met all the requirements of documentation for the radiological test the neurologist could bill for an interpretation using the appropriate CPT code, e.g., 70540, magnetic resonance (e.g., proton) imaging, orbit, face and neck; without contrast material(s), with modifier -26 (professional component) attached.
 
Note: Guidelines for billing radiology services can be found in the introduction to Radiology portion of CPT.