Monday, August 9, 2010

radiology procedure under SNF setting

SNF Billing and Intermediary (FI) Payment for Contrast Material Other Than Low Osmolar Contrast Material (LOCM) (Radiology)

When a radiology procedure is provided with contrast material, a SNF should bill using the Procedure code-4 code that indicates “with” contrast material. If the coding does not distinguish between “with” and “without” contrast material, the SNF should use the available code.

Contrast material other than LOCM may be billed separately in addition to the radiology procedure, or it may be billed as part of the amount for the radiology procedure. If the SNF bills separately for the contrast material and the charge for the procedure includes a charge for contrast material, the SNF must adjust the charge for the procedure to exclude any amount for the contrast material. Regardless of the billing method used, charges are subject to the fee schedule.

When billing separately for this contrast material, the SNF should use revenue code 0255 (drugs incident to radiology and subject to the payment limit) and report the charge on the same bill as the radiology procedure. The FI will not accept late charge bills for this service.

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