Reader Questions: Don't Count on 76140 Pay
- Published on Thu, Jul 20, 2006
Question: When is it appropriate to report CPT 76140 (Consultation on x-ray examination made elsewhere, written report) in a hospital setting?
Answer: You may report CPT 76140 when a patient brings the x-ray or another physician sends an imaging study to your physician for an opinion, and then your physician reviews the films/images and completes a formal report with an interpretation.
Caution: Don’t report 76140 for reviewing old films at the time the radiologist interprets the patient’s current films. Example: Interpretation of a mammogram should include comparison of the new exam to the patient’s prior mammograms. Also, if you are coding for an E/M service, the review of the patient’s imaging studies is part of the medical decision-making element of the E/M level.
Code 76140 should be reported per exam, not per film. Depending on payer policy, you may be able to report multiple units of 76140 if the consultation involves films from multiple exams (for example, CT of the thorax and CT of the abdomen).
Reality: Most payers (including Medicare) do not assign any RVUs or APCs to 76140, so don’t be surprised if you are not reimbursed when reporting this code. In the past, some Medicare carriers have advised physicians to report the exam code (for example, 70450-26, Computed tomography, head or brain; without contrast material-Professional component) rather than 76140 when another physician asks for a written consultation on outside films.
Be sure to verify with your carrier that this is an acceptable practice.
Radiology Coding Alert
Issue - Jul, 2006