Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

MRI BILLING FOR THE PA

Invictus Posted Fri 12th of December, 2014 11:53:48 AM

MEDICARE IS NOT PAYING US FOR THE PA BILLING FOR THE MRI. HOW ARE WE TO GET THESE PAID. CAN A PA BILL FOR MRI IN OKLAHOMA?

SuperCoder Answered Fri 12th of December, 2014 12:37:34 PM

Thank you for your question.
Is the PA performing the MRI or doing an interpretation?

Invictus Posted Tue 23rd of December, 2014 16:00:05 PM

The PA is ordering. We have a MRI tech that performs the services. and we send them out to be read by another company. but we bill for both the professional and technical component.

Invictus Posted Tue 06th of January, 2015 12:34:17 PM

WE need further clarification on this question.
OKLAHOMA PA STATE SCOPE OF PRACTICE LAWS READ,
"Health care services" means services which require training in the diagnosis,
treatment and prevention of disease, including the use and administration of drugs, and which are performed by physician assistants under the supervision and at the direction of physicians. Such services include, but are not limited to:

C. ordering, performing or interpreting, at least to the point of recognizing
deviations from the norm, common laboratory, radiological, cardiographic and other routine diagnostic procedures used to identify pathophysiologic processes,

WE ARE ORTHO/SPINE GROUP WITH ONSITE MRI. OUR PHYSICIAN'S ALONG WITH THE RADIOLOGIST WHO PERFORMS READS SUPERVISE THE MRI DEPARTMENT AND RAD TECH PERFORMING THE MRI.
WHEN DIAGNOSING AND TREATING A PATIENT THE PA MAY ORDER AN MRI, HOWEVER, THE PA IS NOT SUPERVISING THE MRI DEPARTMENT OR STAFF. ALL PA DOES IS ORDER THE MRI, TO DIAGNOSIS AND TREAT, RADIOLOGIST READS AND PROVIDES REPORT AND RESULTS OF MRI BACK TO PA.
SINCE PA ORDERS MRI THE CHARGES ARE BILLED UNDER PA. HOWEVER, MEDICARE DENYING THE MRI STATING PA CANNOT SUPERVISE OR PERFORM SERVICES..
YOUR HELP IS APPRECIATED.

SuperCoder Answered Tue 06th of January, 2015 16:41:51 PM

Researching, will provide a response within 24 hours.

SuperCoder Answered Tue 06th of January, 2015 16:45:51 PM

Thanks for your patience. Please allow additional time to research this question.

SuperCoder Answered Tue 06th of January, 2015 16:45:51 PM
Researching
SuperCoder Answered Wed 07th of January, 2015 16:20:49 PM

Thank you for your patience.

If you are billing out global, for the professional and technical component, you would use the provider to did the most service. Example the provider who did the interpretation and report...however in this case is sounds like you outsource for this part of the service if I am understanding correctly. If you are billing for the professional part, it would be my understanding that the radiologist that reads the MRI is under some type of contract with your office?

Ideally you would bill out the radiologist that interprets the MRI and does the report.

Related Topics