Radiology Coding Alert

Question: I work in an urgent care facility, and my revenue cycle team is trying to determine how to correctly code radiology services with modifiers. For example, one provider orders X-rays and documents a wet read of the images, and then another provider interprets the X-rays after the first provider leaves for the day.

Do we need to bill for both providers?

Idaho Subscriber

Answer: Your team can use a couple coding options to report X-rays at an urgent care facility depending on different factors.

The first option is to report the global CPT^® code for the X-ray procedure without any modifiers if the facility owns and performs the radiology procedure in house. In that case, you’ll assign the X-ray code without TC (Technical component) or 26 (Professional component) if both the technical and professional components are performed at your urgent care.

On the other hand, the second provider in the scenario you presented should receive reimbursement for their professional services in interpreting the X-ray images. You might need to submit two separate claims to the payer listing the first provider’s services performed during the visit, which do not include charges related to the X-rays. You’ll submit another claim for the second provider’s services, which include the global X-ray code for the date of service (DOS) since they are interpreting and signing the radiology report.