Wiki Coding -26 mod on Xrays and MRI?

[LisaG81]

I'm curious to know if any of you are billing for the professional component of xray and/or MRI interpration when a patient brings their own images with them to an office visit. It's happened more than once where our surgeon disagrees with the radiologist's findings when they review the image, so we feel like we should bill for that.

We have been billing -26 on xrays, but does anyone bill -26 for an MRI? Thanks in advance!

 

[kberry9352]

Kimberly Berry, CPC, RCC

So is the Radiologist also billing the prof comt on the same service?

 

[MarcusM]

My understanding is the treating doctor can also bill for his interpretation, especially if he disagrees with the interpreting radiologist. A report must be generated by the treating doctor explaining his opinions and why he disagrees with the radiologist. The treating cannot just regurgitate the radiologist's impressions and then bill for this as a separate interpretation. A simple review of the images is covered under the E&M coding.

 

[OCD_coder]

We have learned by trial and error. If the patient brings films that were formally read by another radiologist/provider and billed by that provider, a modifier 26 and 77 need to be appended or it will potentially deny.