Wiki NEW G CODES FOR RADIOLOGY SERVICES 2020

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AHearley

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Green Bay, WI
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Is there anyone that bills for the professional component only of radiology services? if so are you adding the g1000 series codes to your charges for high dollar imaging services for 2020. From what i have read it seems that these are for the referring md and the facility? Any info would be greatly appreciated !
 
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AmandaBriggs said:
We bill the both the technical and pro-fee components of radiology services and are attaching the "QQ" modifier and "M" modifiers along with the corresponding G codes to the advanced imaging claims for both the facility and the provider. MLN Matters Number MM 11268 discusses this in detail. Here is the link:
https://www.cms.gov/Outreach-and-Ed...-MLN/MLNMattersArticles/downloads/MM11268.pdf
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Hi Amanda,
Our hospital has built a workflow for the AUC, M and G modifiers and is still in testing stages. In a perfect world, the M codes will be coming through from the ordering physician. I have found instances where there is no M code and cannot tell if a decision tool was queried or if the decision tool was queried, but there was no response. What are you doing in this scenario? Are you using the MH - unknown if ordering professional consulted a clinical decision support mechanism for this service, related info not provided to the furnishing professional or provider. I am concerned if this code is used too many times, will raise a flag as well as if Radiology will be denied for missing M modifiers on CT's and MRI's. Or, if there is no code, is it appropriate for the coder to query the ordering provider? Thanks for your advice.

Thanks!
Christina
 
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