Tuesday, July 6, 2010

Radilogy required authorization

Unlisted Services

Radiology services not covered by listed Procedure-4 procedure codes should be billed with the appropriate unlisted Procedure-4 code.  The following Procedure-4 unlisted codes require authorization on a Treatment Authorization Request (TAR):

Procedure-4 Code    Description
76496    Unlisted fluoroscopic procedure (eg, diagnostic, interventional)
76497    Unlisted computed tomography procedure (eg, diagnostic, interventional)
76498    Unlisted magnetic resonance procedure (eg, diagnostic, interventional)
76499    Unlisted diagnostic radiographic procedure

Include a comprehensive report of the service billed in the Remarks field (Box 80)/Reserved for Local Use field (Box 19) of the claim or as an attachment to the claim.

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