tci Part B Insider - 2014 Issue 42

Part B Coding Coach: Dodge Double-Billing Interp Claim Mishaps With This Advice

You may not always be able to report the CPT® code, but discover this big benefit. When your orthopedic surgeon does the interpretation for magnetic resonance imaging (MRI), computed tomography (CT) scan, or other diagnostic test, you may run into hospital policy specifying only a facility radiologist can perform the interpretation. If so, coding your orthopedist’s interpretation would mean you’re guilty of double-billing. But it’s not all bad news. When the orthopedist cannot bill separately for the interpretation, you can still consider the test as a factor in medical decision making when assigning an E/M level...

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