Coding tips for Diagnostic Imaging and Laboratory codes

Diagnostic Imaging

If the treating chiropractic provider refers the reading or interpretation of a radiology service to a radiologist, reimbursement for the professional component of that service will only be made to the radiologist, and the treating chiropractic provider should not bill for that component.


Component Modifier Description of Services

• Professional 26 Services rendered by a licensed practitioner to perform the diagnostic interpretation of each study. It is required to document the diagnostic conclusions of the study by a written and signed radiology report.

• Technical TC Radiology services that include providing the facilities, equipment, resources, personnel, supplies and support needed to perform and produce the diagnostic study.

• Global N/A Combines both the technical and professional components in the service provided.


Laboratory

BlueCare, BlueMedicare HMO, BlueMedicare PPO and BlueOptions members covered in-office laboratory services are restricted to:
81000, 81001, 81002, 82947, 82948, 85014, 85025 All other laboratory services should be referred to Quest Diagnostics, Inc.
For BlueChoice and Traditional members, members may be referred to any Florida Blue contracted laboratories, including Quest Diagnostics.

Laboratory services for select health and musculoskeletal conditions may comprise one or more of the procedure codes on the list of in-office laboratory codes. Reimbursement for routine venipuncture for collection of specimen (36415) is only payable when paired with modifier 90 and when the laboratory sample is drawn in the chiropractor’s office, but the sample is sent to an offsite laboratory for processing.