Practice Management

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  • 1.  Radiologist Location?

    Posted 06-13-2024 07:23

    Hello,

     

    Are any of your radiologist reading from home?

    If so, what location are you using for billing purposes, their home address or the location of the patient receiving services?

     

     

    Thank you,

     

    Pamela

     

    Pamela Mazur, CPC

    Coding Manager with MCBS, LLC

    MCBS Logo - Email

     



  • 2.  RE: Radiologist Location?

    Posted 06-13-2024 09:00

    For traditional Medicare, you have to report the address where the physician is sitting, unless you're billing globally and the physician is sitting in the same locality, in which case you can use the TC address.  Of course, that also means that physician location has to be added to Medicare enrollment, and the claim has to go to the MAC that covers that address.  Payment will be based on the GPCI adjusted fee schedule for that address. 

     

    See Chapter 13, Section 150 of the Medicare Claims Processing Manual at https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c13.pdf

     

    Otherwise, we would use the TC location.

     

    Dave

     

           David Smith, FACMPE  |  Executive Director  |  913.444.9359

    5800 Foxridge Dr.  Ste 240  |  Mission, KS  66202  |  www.uickc.com

    p-uic-horizontal-03a

     

                                                              Member of

     

                             

     






  • 3.  RE: Radiologist Location?

    Posted 06-13-2024 09:33
      |   view attached

    David's email is spot on. You report the address where the physician performed the interpretation unless that location is an unusual and infrequent location. See Q&A #3 in the attached FAQ.

     

    Thomas W. Greeson

    Partner

    Life Science Health Industry Group

    He/Him

     

    email@reedsmith.com

    D: +1 703 641 4242

    M: +1 703 517 0495

     

    Reed Smith

    7900 Westpark Drive

    Suite T700

    McLean, VA 22102

    T: +1 703 641 4200

    F: +1 703 641 4340

    reedsmith.com

     


    This E-mail, along with any attachments, is considered confidential and may well be legally privileged. If you have received it in error, you are on notice of its status. Please notify us immediately by reply e-mail and then delete this message from your system. Please do not copy it or use it for any purposes, or disclose its contents to any other person. Thank you for your cooperation.

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  • 4.  RE: Radiologist Location?

    Posted 06-13-2024 14:22

    In case you missed it, Healthcare Administrative Partners just posted a great summary of these rules.  Here's the link:

    https://info.hapusa.com/blog-0/use-caution-when-billing-for-remote-radiology-reading

     

    John

     

    ---

        John E. Pugh

     P: 609.644.4479

     F: 609.503.2476

    A picture containing logo  Description automatically generated

     






  • 5.  RE: Radiologist Location?

    Posted 06-13-2024 09:54
    David's direction is spot on.  Unfortunately, implementation of this advice can get very complicated and time consuming.  


     I would love to see the RBMA have a roundtable or live webinar on this matter.  



     
     
     
    Sheila S. Witous, MBA, CPA
    Chief Administrative Officer
    Radiology, Inc.
    P.O. Box 1258
    South Bend, IN 46624
    (574)258-1100 ext. 205







  • 6.  RE: Radiologist Location?

    Posted 06-13-2024 10:44
      |   view attached

    I appreciate the guidance, I read an article where this is being appealed by AHA and for telehealth CMS had allowed location to be used where patient was sitting until end of the year.

    Just wasn't clear if radiology was included. See attached letter.

     

    Thank you very much!

     

    Pamela

     

    Pamela Mazur, CPC

    Coding Manager with MCBS, LLC

    MCBS Logo - Email

     






  • 7.  RE: Radiologist Location?

    Posted 06-13-2024 11:13

    CMS doesn't consider teleradiology to be telehealth.  Telehealth is generally E&M.  There is a list of specific codes that can be rendered via telehealth.

     

    Dave

     

           David Smith, FACMPE  |  Executive Director  |  913.444.9359

    5800 Foxridge Dr.  Ste 240  |  Mission, KS  66202  |  www.uickc.com

    p-uic-horizontal-03a

     

                                                              Member of

     

                             

     






  • 8.  RE: Radiologist Location?

    Posted 06-13-2024 11:51

    How is teleradiology used? Still getting my feet wet in radiology 😊

     

    Thank you,

     

    Pamela

     

    Pamela Mazur, CPC

    Coding Manager with MCBS, LLC

    MCBS Logo - Email

     






  • 9.  RE: Radiologist Location?

    Posted 06-13-2024 11:52

    Teleradiology is basically any read done at a location remote from the technical component.

     

    Dave

     

           David Smith, FACMPE  |  Executive Director  |  913.444.9359

    5800 Foxridge Dr.  Ste 240  |  Mission, KS  66202  |  www.uickc.com

    p-uic-horizontal-03a

     

                                                              Member of

     

                             

     






  • 10.  RE: Radiologist Location?

    Posted 06-13-2024 11:16

    The professional component of a radiology service has long been considered to be a physician service, and it has been regulated as such rather than under the telehealth rules.

     

    Thomas W. Greeson

    Partner

    Life Science Health Industry Group

    He/Him

     

    email@reedsmith.com

    D: +1 703 641 4242

    M: +1 703 517 0495

     

    Reed Smith

    7900 Westpark Drive

    Suite T700

    McLean, VA 22102

    T: +1 703 641 4200

    F: +1 703 641 4340

    reedsmith.com

     


    This E-mail, along with any attachments, is considered confidential and may well be legally privileged. If you have received it in error, you are on notice of its status. Please notify us immediately by reply e-mail and then delete this message from your system. Please do not copy it or use it for any purposes, or disclose its contents to any other person. Thank you for your cooperation.

    RSUSv12021