tci General Surgery Coding Alert - 2003 Issue 12

You Be the Coder: Charging for Radiology Procedures

Question: A patient presented for follow-up four months after surgery. The physician provided an E/M service (99212) and a complete radiologic exam (72052). Can I report both services and, if so, must I attach modifier -25 to 99212?Missouri SubscriberAnswer: Unless another physician specifically asks the surgeon for his or her opinion, the "re-read" of an x-ray previously interpreted by another physician such as a hospital radiologist counts only toward the "Amount and Complexity of Data" section of Medical decision-making. You may not report the service separately, because this would constitute "double-billing." If you provide the x-ray in...

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