CPT code 76140 is used for an X-ray consultation, indicating a professional review and interpretation of X-ray images by a healthcare provider.
CPT code 76140 is used to describe a consultation on X-ray examination made by a radiologist or other qualified healthcare professional. This code is typically utilized when a healthcare provider seeks the expertise of a radiologist to interpret X-ray images and provide a detailed report or opinion on the findings. It is important to note that this code is specifically for the consultation service and not for the actual taking of the X-ray images. This service is crucial in ensuring accurate diagnosis and treatment planning based on the X-ray results.
For the CPT codes provided, here are the potential modifiers that could be applicable:
1. Modifier 26 (Professional Component): This modifier is used when only the professional component of the service is provided. It indicates that the service was performed by a physician or other qualified healthcare professional, and not the technical component.
2. Modifier TC (Technical Component): This modifier is used when only the technical component of the service is provided. It indicates that the service was performed by the facility or technician, and not the professional component.
3. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if the x-ray services are performed in conjunction with other procedures that are not typically reported together.
4. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
5. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
6. Modifier 52 (Reduced Services): This modifier is used when a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified healthcare professional.
7. Modifier 53 (Discontinued Procedure): This modifier is used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 99 (Multiple Modifiers): This modifier is used when two or more modifiers are necessary to describe the service provided.
These modifiers help in accurately reporting the services provided and ensuring appropriate reimbursement. It is important to review payer-specific guidelines as they may have unique requirements for modifier usage.
The CPT code 76140 is not typically reimbursed by Medicare. According to the Medicare Physician Fee Schedule (MPFS), this code is often considered a bundled service, meaning it is included in the payment for other services and not separately reimbursed.
Medicare Administrative Contractors (MACs) may have specific guidelines or policies regarding the reimbursement of this code, but generally, it is not separately payable under Medicare.
Healthcare providers should consult their local MAC for any specific coverage details or exceptions that might apply.
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