Medicare Compliance & Reimbursement - 2008 Issue 12
Reader Questions: Think Twice When Billing X-ray, MRI Interpretations
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Article Overview
This reader question discusses whether a surgeon can separately bill for reviewing x-ray and MRI studies performed at an outside facility. It focuses on the distinction between interpretation, documentation, and use of imaging findings in evaluation and management, and it is aimed at physicians, surgeons, coders, and compliance staff.
Why This Topic Matters
Imaging interpretation claims can be denied or duplicated if the service has already been reported elsewhere or if the work is part of the broader visit. The article helps readers understand the documentation and reporting context needed to evaluate whether a separate professional service is being billed.
What You Will Learn
- How outside imaging reviews may be treated in billing workflows
- How documentation affects whether imaging interpretation is separately reportable
- How imaging findings can relate to evaluation and management services
- How compliance teams think about duplicated interpretation claims
Who Should Read This
- Surgeons
- Physicians
- Medical coders
- Billing staff
- Compliance staff
Modifiers Discussed
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