Question

What CPT codes and or modifiers would be used for questions 1-5?

1. A primary care physician took a two view chest x-ray (frontal and lateral views) in his office. The films were sent to a radiologist (who was not affiliated with the primary care physician) to be interpreted. The radiologist billed separately for her services. How should the radiology-related services provided by the primary care physician’s office be reported?

2. How should the radiologist in the above questions report her professional services?

3. A radiologist interpreted a head CT scan taken by the hospital. The study included both films taken without contrast and films taken with IV contrast material. How should the radiologist’s professional services be reported?

4. A mammography was performed for a patient with a suspicious breast lump. Only one breast was studied. The service was provided in a freestanding women’s imaging center owned by a large radiology practice. The study confirmed a neoplasm. A copy of the radiology report was sent to the patient’s primary care physician. How would the radiology practice’s services be reported?

5. A radiologist interpreted a MRI without contrast of the orbit, face, and neck taken by the hospital. The radiologist also interpreted a soft tissue x-ray of the neck taken by the hospital. The interpretations of both studies were included in a single radiology report under separate headings. How should the radiologist’s professional services be reported?

Answer 1

1) 71020 is the CPT code used for chest x-ray 2 views. Also modifier 59 is appropriate in this case.

Primary care physicians are responsible to make the initial evaluation of the patient and to investigate appreciate treatment according to patients condition. Some conditions can be diagnosed clinically but require imaging to confirm it. Therefore, the radiology services must be in a position to respond by an urgent appointment with an immediate report transmitted to the primary care physician verbally or by electronically.