Oncology & Hematology Coding Alert

Question: Should we append modifier -26 to 76140 when the oncologist consults on x-rays?

Wisconsin Subscriber

Answer: Because CPT designates 76140 (Consultation on x-ray examination made elsewhere, written report) only for the physician, you do not need to append modifier -26 (Professional component) to the code. 
 
Typically, you should use 76140 if a physician from another institution requests your physician's opinion on a radiograph and you send that physician the interpretation. You should not report 76140 if an oncologist within your practice asks your physician to reread an x-ray that another physician within the same practice interpreted. Instead, report 76140 when your oncologist interprets an imaging study that a physician from another practice and with a different provider number obtained and interpreted.

 - Answers to Reader Questions and You Be the Coder were reviewed by Linda L. Lively, MHA, CCS-P, RCC, CHBME, founder and CEO of American Medical Accounting and Consulting in Marietta, Ga.; and Margaret M. Hickey, MS, MSN, RN, OCN, CORLN, an independent coding consultant based in New Orleans.