Arul karthik Posted Wed 09th of May, 2018 01:06:42 AM
Can you clarify whether we can bill chest x-ray which is done by Radiologist & Pediatric critical care (99471 -99476) which is done by Cardiologist on the same day. Will chest x-ray be paid separately?
SuperCoder Answered Fri 11th of May, 2018 04:08:18 AM
There can be two scenarios for the above documentation.
- If both the providers (radiologist and cardiologist) performed the chest x-ray within the critical care service time; then it would be considered inclusive. In this case, report only Paediatric critical care E/M code ONLY.
- If both the providers (radiologist and cardiologist) performed the chest x-ray outside the critical care service time; then you may report both the Paediatric critical care E/M code and chest x-ray.
Note: Both the providers should have a separate radiological report of the chest x-ray to get separate reimbursement on the billed date of service.
Also, append modifier-59 (on chest x-ray CPT code) to override the bundling conflict between the E/M code (Paediatric critical care) and chest x-ray procedure, when the chest x-ray was performed outside the critical care service time.
Kindly check your medical documentation for the above-mentioned scenarios before reporting.
Hope that helps!