Wiki Technical vs Professional Component for xrays

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skincer

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Patient presents with pain and xrays are taken. The physician decides to give these films to the patient who promises to return them the next day. Medicare is billed and pays for the global fee for the xrays, but the patient now doesn't want to return the films nor does the patient intend to. Is this billed correctly to Medicare or should the claim be corrected to professional component only? If there is any reference in CMS you can attach, please do so. Can the patient be billed for the films?
Thanks so much in advance for all reponses!
skincer
 
Let's say this is a 2v chest, 71020 that was done. The taking of the xray is 71020-TC and you did that part. The written interp of the xray is 71010-26. Is the written interp report usually dictated by your physician or a Radiologist? Was this done prior to giving the films to the patient?

If both -TC and -26 componets were completed then your claim to Mcare is correct as 71020. If the written interp report was not done, then you must correct your claim to Mcare to only 71020-TC
 
Yes, both technical and professional components were completed by the physician and there is a report. However, because the patient has the films and they are not in the office, should we change the billing to professional component only?
 
No, the fact the patient won't return the films does not change the coding of the serivce since you did both -TC and -26

If you took the xrays, then the films are your property and are part of the medical record. You can bill the patient if they have stolen/taken/borrowed/absconded with the clinic's property. Or you can forget it and just not see them again.
 
But, the films are not part of our medical record because the patient has them...we have NO films in the medical record. The patient in fact did borrow them and we're unsure if she'll return them or not. Bad decision made to release our original films, I know, but if Medicare comes in and wants to see the films (because we billed global) and we don't have them, isn't that a violation?
 
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