RADIOLOGY OVERVIEW

A radiologist is a medical doctor who specializes in diagnosing and treating disease and injury by using medical imaging techniques such as X-rays, Computed Tomography (CT), MRI, Positron Emission Tomography (PET), fusion imaging and ultrasound.

Acceptable HCPCS codes for radiology services are taken primarily from the Procedure code portion of the HCPCS. Payment is based on the lower of the charge or the Medicare Physician Fee Schedule amount. Deductible and coinsurance apply.

An International Classification of Diseases, 9th Revision, ICD-9-CM diagnosis code must be submitted on all claims along with the name and National Provider Identifier (NPI) of the ordering physician. Physicians should report diagnoses based on test results.