Radiology Coding Alert

Question: Our radiologist was called upon to analyze chest X-ray images (frontal) for a patient with viral pneumonia. How can we bill for X-ray interpretation when the office does not own or lease the equipment?

Florida Subscriber 

Answer: As you do not own the equipment, you can only report the professional component of the service.

What are the professional and technical components? The professional component includes the physician’s work of interpreting the results and issuing a report whereas the technical component of the service covers labor, equipment, and supplies. All the radiological services – and hence the corresponding codes (70010-79999) – in the CPT^® manual include both the professional and technical components of the procedure.

If the physician who is reading the report also owns the equipment, he would straightaway bill for code such as 71010 (Radiologic examination, chest; single view, frontal).

Check for modifiers: In case of one or the other condition not being met for 71010, you will have to use modifiers that are used with these X-ray codes to specify the components which the billing physician handled. You will use modifier 26 (Professional component) appended to the radiologic code when the physician performs only the professional component, such as interpretation. You append modifier TC (Technical component) to the X-ray code to show that the physician owns the equipment and wants to recover the reimbursement for the technical component. Since your physician does not own the equipment, you can only report the professional component (71010-26), because this involves the interpretation of the films and the report of findings.

Remember to include the relevant diagnosis code 480.2 (Pneumonia due to parainfluenza virus). Under ICD-10, you would diagnose the same condition as J12.2 (Parainfluenza virus pneumonia).