Wiki Rules re: radiology, lab and path services during follow up visits

[nvlimbo]

Does someone have the actual ruling from CMS re: radiology, lab and pathology services being payable if performed for a follow up visit after a major surgery (with 90 days post op period)?

 

[jbaird]

You can start with the physician RVU file. It is a huge excel file that will give you the number of days post op if it applies by CPT code. Go to:
http://www.cms.hhs.gov/PhysicianFee...=ascending&itemID=CMS1230197&intNumPerPage=10
When you download the files you want to view the bottom two files the excel worksheet titled PPRRVU10 and the acrobat file will translate what each of the columns mean.
I believe there is a separate file for Lab. I haven't billed for lab. You may start here if you don't find what you need in the physician fee schedule files:
http://www.cms.hhs.gov/FeeScheduleGenInfo/
I hope this is what you were looking for.