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Limited Study

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.

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