Dr Nager (Alan):
I wanted to add to what Dr's. Parker, King and Herman already stated. Yes, under Medicare rules,radiology can also be reimbursed for overreads. Utilizing a -77 modifier, a repeat service by another physician is recognized. You can structure it such that, when you order a radiograph it is an implied radiology consult for a delayed over read.
One arrangement to consider as you dialogue with the hospital administration and radiology departments, is for ya'll to bill for services rendered after 5 pm, if they are unable to provide real time reads 24/7.
I strongly believe that we need to confront this issue eventually. On a similar note, why should ED billing for bedside FAST ultrasound (76705) say, be any different from a concurrent plain radiographic reading by the ED?
I am not suggesting confrontation, however, the reality is that contemporaneous radiology interpretation by emergency physicians, with their attendant risks, are not encompassed in the standard point system for E&M coding levels. So, how do we incorporate this part of the service we render??
I feel your pain ......
Jay Pershad, MD, FAAP
Division of Pediatric Emergency Medicine
UT College of Medicine
LeBonheur Children's Medical Center
Memphis, TN 38103
Pediatric Emergency Specialists, PC
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