I have recently run across a situation where the ER doctor is not only billing a E/M code, but also the x-ray codes with modifier 26. However, I'm also receiving bills from the radiologists billing for the same DOS and same x-ray code with the modifier 26. The notes 9/10 list the radiologist's name. Our system sees these as duplicates. My question is, can a ER doctor bill for the x-ray or should those charges be included in the E/M code or should we process them as adjustments?
Note: The OP hospital bills the diagnostic, which is considered the TC and is paid for without a problem.
Note: The OP hospital bills the diagnostic, which is considered the TC and is paid for without a problem.