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modifer 26 for radiology

Brenda Posted Mon 25th of January, 2010 20:33:15 PM

Is it appropriate to bill w/mod 26 attached to a cpt code for an MRI if my phys. has the pt bring in the actual films for him to review even though the films were intially read by the radiologist at the facility where they were done? Or can only one phys bill for the reading??

Thanks for any help.

Alan Answered Mon 01st of February, 2010 12:14:44 PM

You are correct. Only one physician can bill for reading the result of a radiological service. Actually in this case the physician (ordering physician) should bill the MRI procedure code with 26 modifier. Both the physicians cannot claim for payment for providing professional service (reading the MRI data) on the same set of MRI result.

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