Practice Management

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

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

                                                          Member of

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

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

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

                                                          Member of

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

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

                                                          Member of

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

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

                                                          Member of

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

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

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

                                                          Member of

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

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

                                                          Member of

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

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

                                                          Member of

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

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

Thank you,

Pamela

Pamela Mazur, CPC

Coding Manager with MCBS, LLC

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

                                                          Member of

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

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

                                                          Member of

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

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

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

                                                          Member of

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