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Posted By Roach, on 07-15-2005, 10:24:00 in Orthopedic
Two of my docs saw patients yesterday where they had to read the mri films
that the patient brought with them. They are asking me if there is a code
for this interpretation? I beleive it's added into the E&M code, maybe go
to a higher level? Any thought on this? Thanks!
Comments (5)
Posted By Denise on 07-17-2005, 18:18:00
I think the code that others may use for this type of evaluation is 76140,
though its been argued that the re-reading of outside films is already
included in the E/M (unless the re-reading produces a significantly
different impression.)

Denise Paige, CPC
Posted By Bill on 07-17-2005, 16:08:00
At 01:06 PM 7/17/2005, you wrote:

>I know of a lot of things that shouldn't be billed, that are billed and>paid for by insurance companies.
>I am sure most will agree that just because it gets paid, doesn't mean it >should have been billed.
>
>Just my 2 cents.

Agree and don't agree. The insurance companies will take every advantageof us to avoid paying us. If we can find a way to get paid, and it is not
outright illegal or fraud, we should also take advantage of it. Again, not
advocating anything illicit, but use every edge you can get.


Bill M
Posted By Kim on 07-17-2005, 15:28:00
I know of a lot of things that shouldn't be billed, that are billed and paid for by insurance companies.
I am sure most will agree that just because it gets paid, doesn't mean it should have been billed.
Just my 2 cents.
Posted By Bill on 07-17-2005, 10:38:00
Interesting question that has come up in our group recently. Our new MD
did a spine fellowship at Texas Back Institute and said that they did
charge for outside MRI review and got paid for it.

99358 is for prolonged E/M service and not definitely related to reviewing
MRI. It rarely takes very long to review an MRI for us - 5-10 minutes at
max. Not sure this applies.

What are the other coders opinions? Are you getting paid for this? Is
99358 a code that works for this situation? I'm going to forward this to
our head coder as well and maybe we can get something for this.


Bill
Posted By Kristi on 07-15-2005, 13:23:00
Yep - part of E/M, counts towards amount or complexity of data reviewed for
medical decisionmaking component.

Kristi Stumpf CPC
Proliance Surgeons Certified Professional Coder
425-454-5344
k.stumpf@proliancesurgeons.com
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