Ask Dr. Z

We bill for the radiologists who are employed by a hospital system. They are required to provide the interpretation for all imaging procedures performed and have decision-making authority for protocols, as well as provide supervision to the technologists. When they are performing the final written interpretation for radiology procedures that include an S&I component (particularly, e.g., angiography and aortography) we are billing with only a -26 modifier. I have seen recommendations that we should also append a -52 modifier, which I am challenging based on our organization structure and protocol. Also during some IR procedures (e.g., cholangiograms) I see recommendations that the interpreting radiologist can only bill for the intraoperative spot films performed instead of the cholangiography initial and additional sets (74300-74301). We have been billing the cholangiography. Should we only be billing the abdominal films (74000)?