Camille Posted Wed 21st of March, 2012 18:31:13 PM
If a patient presents for an MRI or Cat Scan and they were only able to capture a partial image and not be able to complete the report. Is there a billable code.
If the patient comes back again for the complete study can we bill the CPT code again?
SuperCoder Answered Wed 21st of March, 2012 21:13:26 PM
According to the Medicare Claims Processing Manual, Chapter 13, Section 100.1, -A professional component billing based on a review of the findings . . . without a complete, written report similar to that which would be prepared by a specialist in the field, does not meet the conditions for separate payment of the service.-
Also, always remember to apply modifier 26 (Professional component) if the physician performs the service in a hospital setting
If the patient comes back again for the complete study, bill the CPT again.