Radiology Coding Alert

Question: Would you explain the "physician supervision of diagnostic services" section of Medicare's Fee Schedule ?


New Hampshire Subscriber

Answer: The Medicare Fee Schedule supervision indicators show the level of physician supervision required for a diagnostic test if it's performed in a physician office, imaging center, or IDTF. Important: These rules don't apply to diagnostic tests performed in an inpatient or outpatient hospital setting.

Level 01 is general supervision. The procedure is furnished under the physician's overall direction and control, but the service doesn't require the physician's presence during the procedure. Examples include plain films, most ultrasounds, and CT or MRI without contrast.

Level 02 is direct supervision. The physician must be present in the office suite and immediately available to furnish assistance and direction. The physician doesnot have to be in the room where the test is being performed, however. Examples include exams using intravenous contrast.

Level 03 is personal supervision. The physician must be in attendance in the room during the procedure. Examples include hysterosalpingogram and transesophageal echocardiogram.

Level 09 is "concept does not apply."

Protect yourself: Check payer policy information, CPT guidelines, and fee schedule data to determine what level of supervision your payer requires for each code.