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Coding Questions

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  • opsmd
    Coding Gurus, I would appreciate any help on the following questions: 1.If a physician takes an xray in his own office, reads it, documents it in the patient
    Message 1 of 3 , Oct 17, 2002
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      Coding Gurus,

      I would appreciate any help on the following questions:

      1.If a physician takes an xray in his own office, reads it, documents
      it in the patient visit note, and gives the patient the result and
      does not send the xray out for another interpretation, how does he
      get paid for both the technical and professional component? Is there
      a modifier that indicates both, does he bill the codes twice with a -
      TC and -26 modifier, etc.

      2.If a physician does an EKG in the office at a patient's visit,
      reads the results and documents it in the patient's visit note, how
      does he get paid for both the technical and professional component?
      Does he need to charge an interpretation separately?

      Any advice would be greatly appreciated.

      Thanks,
      AGA
    • bexx1232000
      In this example, you bill the xray code with NO modifier. With no modifier, you are paid for both the technical and professional component. I bill for a
      Message 2 of 3 , Oct 17, 2002
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        In this example, you bill the xray code with NO modifier. With no
        modifier, you are paid for both the technical and professional component.

        I bill for a chiropractor and do this every day.

        Becki


        >
        > 1.If a physician takes an xray in his own office, reads it, documents
        > it in the patient visit note, and gives the patient the result and
        > does not send the xray out for another interpretation, how does he
        > get paid for both the technical and professional component? Is there
        > a modifier that indicates both, does he bill the codes twice with a -
        > TC and -26 modifier, etc.
        >
        > 2.If a physician does an EKG in the office at a patient's visit,
        > reads the results and documents it in the patient's visit note, how
        > does he get paid for both the technical and professional component?
        > Does he need to charge an interpretation separately?
        >
        > Any advice would be greatly appreciated.
        >
        > Thanks,
        > AGA
      • Laureen Jandroep
        Hi, See my comments below. Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS School Director & Sr. Instructor for A+ Career Academy and
        Message 3 of 3 , Oct 18, 2002
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          Hi,

           

          See my comments below.

           

          Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS

          School Director & Sr. Instructor for A+ Career Academy and the CRN Institute

          Specializing in Medical Coding & Billing Training & Videos

          PH: 609-383-8840  -  FAX: 609-383-0757

           

          -----Original Message-----
          From: opsmd [mailto:opsmd@...]
          Sent:
          Thursday, October 17, 2002 6:58 PM
          To: MedicalBillers@yahoogroups.com
          Subject: [MedicalBillers] Coding Questions

           

          Coding Gurus,

          I would appreciate any help on the following questions:

          1.If a physician takes an xray in his own office, reads it, documents
          it in the patient visit note, and gives the patient the result and
          does not send the xray out for another interpretation, how does he
          get paid for both the technical and professional component?  Is there
          a modifier that indicates both, does he bill the codes twice with a -
          TC and -26 modifier, etc. 

           

          Actually by not putting any modifier on it you get paid for both the technical and professional component.  When you put -26 on you’re getting paid less because you’re telling the payor you only did the professional component (i.e.. the interpretation and report)



          2.If a physician does an EKG in the office at a patient's visit,
          reads the results and documents it in the patient's visit note, how
          does he get paid for both the technical and professional component? 
          Does he need to charge an interpretation separately?

           

          These are different b/c there are three codes to choose from 93000 with is the total code and includes the technical and professional component.  If you want to report just the technical you would use 93005 and for just the professional component you would use 93010.



          Any advice would be greatly appreciated.

          Thanks,
          AGA



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