Unlisted diagnostic radiographic procedure

Description

This code is utilized to report diagnostic radiographic procedures that lack a specific CPT designation. It allows for the documentation and billing of services that do not fall under existing codes, ensuring comprehensive coverage of radiographic evaluations.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

$88.05

Calculation:

x=$88.05

Patient Copayment / Coinsurance

$17.61

Calculation breakdown:

Minimum (20% of rate)$17.61

Medicare Ambulatory Surgical Center Reimbursement (ASC)

ASC Payment Rate

—

Patient Copayment / Coinsurance

—

Standard copayment (20%):—

Top Modifiers

Graph View

List View

HCPCS/CPT 26Professional component of diagnostic services(51.66%)

HCPCS/CPT GCServices performed by a resident under the supervision of a teaching physician(8.86%)

HCPCS/CPT TCTechnical component of diagnostic imaging services(5.54%)

HCPCS/CPT LTModifier for procedures performed on the left side of the body(4.8%)

HCPCS/CPT RTRight side procedure modifier(4.43%)

HCPCS/CPT X5Services rendered only as ordered by another clinician(2.95%)

HCPCS/CPT AQService rendered in a health professional shortage area(2.58%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(1.48%)

HCPCS/CPT Q1Routine clinical service in an approved clinical research study(1.11%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(1.11%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)