Wiki X-RAY bundled with E/M service

[MzJones]

Morning All...I am needing some help here with x-rays and e/m services. My ortho doc is billing x-rays, 72170, 73110, or 73560 with the 26 or tc mods along with the E/M services and the carriers are denying stating that these services are bundled. Can someone please tell me the best way to fix this issue?

Thanks

 

[dhuttie]

I've not seen xrays being denied as "bundled" with an E/M service.
If your practice owns the xray equipment, xrays taken at your practice and interpreted by your physician, you should be reporting just the xray code without the -26 or -TC modifier.
Why is the physician/biller adding the modifiers? And are the claims submitted as 72170-26 and again as 72170-TC? If so, that may be the issue.

 

[KMCFADYEN]

I agree with Dhuttie, if you own the equipment, then you bill without any modifier. Xrays are not bundled with E&M and there are no edits for the codes you listed.

 

[MzJones]

Thank you.
here's the situation...
There are 3 physicians in the practice, but the one who owns the equipment has not yet joined the new practice as of yet (as his contract is not up with the hospital...long story). But if Dr. W is there and takes the x-ray then Dr. P reads it then I bill with a mod 26. See my frustration? How do I get around this issue?