Radiology Coding Alert
Interps in a Neighboring State
Delaware Subscriber
Answer: First, you should report any relevant x-ray codes with modifier -26 (professional component) if your radiologists provide only the interpretation (e.g., 70260-26, radiologic examination, skull; complete, minimum of four views, with or without stereo).
The answers about date and place of service are less straightforward and depend on the individual payer. Many local Medicare carriers, for instance, have informed radiology practices to bill the date and place where the films were read (i.e., Delaware on the day the radiologist interpreted the x-rays). Others require practices to bill the date and place where the x-rays were obtained (i.e., the New Jersey clinic on the day the films were taken). However, because these are pediatric films, many of the patients will not be Medicare beneficiaries. Therefore, you need to check with individual insurers and local Medicaid officials. For Medicaid patients, your office may need to be a provider in both states.
Your practice must also determine whether a radiologist at the New Jersey facility is conducting an initial interpretation and then sending the films on to you for an "over read." If the New Jersey radiologist bills for the interpretation, your practice will not be able to do so.
Radiology Coding Alert
- UAE Involves Three Components Plus Modifiers
Interventional radiology practices consistently receive payment from Medicare and most private insurers for uterine artery [...] - CPT 2002 Introduction Contains Major Change
Radiology coders must pay close attention to language changes in the front matter of CPT [...] - You Be the Coder:
Leg Catheter for Vessel Examination
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Physician Payment Conversion Factor Decreased for 2002
Representatives from CMS explained the decreased conversion factor that will be used to determine payment [...] - Reader Question:
Interps in a Neighboring State
Question: I work for a children's hospital in Delaware. Our radiologists have been asked by [...] - Reader Question:
Ultrasound-Guided Breast Needle Localization
Question: How should I code an ultrasound-guided needle localization (i.e., wire placement) into a breast [...] - Reader Question:
Dialysis Graft Thrombolytic Infusion
Question: If our radiologist performs thrombolytic infusion on a dialysis graft for more than one [...] - UAE Coding Examples Based on Payer Reporting Preference
- Anthrax Coding Report Free on Web
Radiologists and other healthcare professionals who provide services to any patients with actual or possible [...]
