Coding Recommendations

Radiography billing covers 2 components:

  • Technical component (cost of film, processing, and equipment) - about 40% of the global fee
  • Professional component (time and expertise of the clinician) - 60% of the global fee

Choose one of 3 coding options 

This example uses CPT code 72100, a two-view lumbar spine series.

1. If you take and read most or all of your films

You have 2 options a)  A global fee (i.e., 72100) which includes technical and professional components - OR b)  Separate technical and professional components (72100-TC or plus the professional component or reading fee 72100-26). Your report is the primary report. You can get a second opinion by using the 76140 code, when needed.

2. If you have all of your films read by a radiologist

Use 72100-TC for the technical component and 72100-26 for the professional component. You would then pay the radiologist from the 72100-26 component. The primary report will be produced by the radiologist.

3. If you have only some of your films read by a radiologist

This is an overread (second opinion) service. Since a global fee typically has already been billed, you should only use the overread code - 76140. The insurance company considers it double billing for the professional service if you use the -26 extension. Using the 76140 code assumes a primary report already exists.  

Note: Good patient care requires that all radiographs taken include a written interpretation. These reports can be done by the general practitioner or by a board-certified radiologist, sometimes by both.


For questions, contact:

Lynn Schmidt, insurance specialist
lschmidt@nwhealth.edu
952/800-888-4777 ext. 245

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