Wiki Outside Imaging Modifier 26

turnkeymd

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If a patient brings in their outside imaging on a CD along with a copy of the report from the outside provider, let's say an urgent care, can the provider reading the outside image bill for that x-ray with modifier 26? This is for an orthopedic/sports medicine group that sees a lot of acute injuries, many of which have been evaluated at urgent care before seeing the ortho provider. I believe this would be called a re-read of an already interpreted image. I'm looking for a document or resource to support this either way. According to the Modifier 26 Fact Sheet from Novitas, it states it is inappropriate use for Re-read results of an interpretation provided by another physician. However, when I check Noridian (Southern California Medicare Contractor), that statement is not there. I appreciate any help!
 

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