Wiki Who pays for a second reading of an x-ray?

[Cheryl O]

I received a bill today to review and I am not sure how to proceed. The bill came from a radiology group for reading and a written report of an x-ray. The x-ray had already been read by the ordering doc as it was done in the physicians office, and documented by the provider. This x-ray was sent out, basically for a second opinion. My previous experience with these is that the radiologist billed the physicians office for the charge, not the insurance company. The billed CPT code had already been billed and paid to the provider that did the original x-ray. Is it ok to pay for this second reading? I say no, that the radiologist should bill the original providers office. Is this correct?

Thanks in advance to anyone who can help clear this up

Cheryl

 

[mitchellde]

Did the ordering provider provide a separately documented radiology interpretation report? If not then the one that provides this report receives the reimbursement. If the provider did supply the interpretation the the radiologist could bill the radiology code for consultation only. I can never remember this number but there is a CPT code in the radiology section for consultation.

 

[Cheryl O]

Debra,

Thanks alot for the help. I was able to find the CPT code you were talking about and it is just what I needed. Yes, the provider did document from the x-ray, so this consult code will certainly work.

Thanks again,

Cheryl