Forum - Questions & Answers

Aug 27th, 2015 - chelseyd

CT billing for radiation planning


I would appreciate feedback on the following scenario:

A radiation oncologist practice performs CT’s at their facility for radiation planning. A separate group of radiologists reads the study. The radiologist group bills the CPT® code for the appropriate CT (like 72195) with a -26 modifier to the patient's insurance. The radiation oncologist bills globally (which they insist they can do)for 77014 to the patient's insurance.

Is this appropriate or considered “double dipping”? Why or why not? Also, is there a "rule" I am unfamiliar with that they can bill the professional component even though they are not providing a reading?

Thank you in advance,

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