General Question for the Week of February 7, 2022


What documentation is required if our non-hospital imaging center needs to do an exam in addition to that which was ordered by the patient’s treating physician?


According to the Medicare Benefit Policy Manual, chapter 15, section 80.6, if a radiologist at a non-hospital location believes that an additional exam should be performed, he should attempt to reach the patient’s treating physician to get a new order. If that is not possible, all of the following criteria must be met and documented:

  • The testing center performs the diagnostic test ordered by the treating physician/practitioner;
  • The interpreting physician at the testing facility determines and documents that, because of the abnormal result of the diagnostic test performed, an additional diagnostic test is medically necessary;
  • Delaying the performance of the additional diagnostic test would have an adverse effect on the care of the beneficiary
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