12/27/2017

Correct Use of CPT Code 76140

Is The cpt code 76140 used when we are shown an xray from another Podiatrist or hospital, and when would we use the 26 modifier, regarding the same issue?

Code Description:

76140- Consultation on X-ray examination made elsewhere, written report

Lay Description (Code):

A radiologist provides a consultation and a written report after reviewing an x-ray exam that was performed elsewhere.

A physician cannot use this code when the patient simply brings in the x-ray and the physician reviews/interprets the films. (76140) This service follows the same ideology as a consult service. Consult= 3 R's=Request opinion, render opinion, report opinion. If your provider is providing this service at the request of another provider and the criteria is met, you should be reimbursed. However, be prepared to appeal with documentation and make sure to use modifier 26 for the professional component. 

Remember the provider “is not reading it" that's been done already, he's basically looking at it himself and reading what the finders were. Your review can be noted as part of the Evaluation and Management code for meeting the level of service criteria .