Stay Away From ‘double Billing' When Engaged In This Radiology Procedure

By Author: Jaun Paul
Total Articles: 53
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After suffering a blow to the head, a patient showed the following symptoms - dizziness, sleepiness, slurred speech, and confusion. The doctor attending to the patient ordered a CT scan to check for internal injuries and aneurysm. After finding out that there was no evidence of serious injury, the doctor admitted the patient for observation.


Under such circumstances, can the physician biller bill for the interpretation?


The answer is no. The physician biller cannot bill for the interpretation. A facility radiologist or other physician may give interpretations for all ordered tests as a matter of policy in a hospital or other inpatient facility. As such, you being the admitting but not attending/ordering, physician's biller, you are not entitled to reporting the interpretation for 70460.


You need to ensure that only one person reads the diagnostic test and the person billing it should have an all-encompassing report. If your physician reads the films/fluoros and bills for them, then you should keep handy a separate ...
... note with a separate signature at the end of the op.

You probably could not report the CT scan interpretation for your doctor in the above scenario because, very likely, the hospital radiologist would prepare the initial report for the CT scan. Even when your doctor provides the immediate interpretation used for treatment and the radiologist provides an over-read (secondary quality assurance review), hospital rules may give the charge to the radiologist.


Conclusion: So if one physician has already interpreted a test and provided a report outlining the result, no other physician can bill for the same service. This would fall under the category of radiology procedure double-billing.


We provides the latest developments in Healthcare Compliance, and advanced Learning Opportunities about radiology procedure double-billing for healthcare executives and physician billers.