Does 73000 require prior authorization?

No, 73000 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 73000?

Medicare facility rate: $2.70. Non-facility rate: $2.70. Work RVU: 0.16.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.16

Facility

$2.70

Non-Facility

$2.70

Use the days/units field when possible to identify multiple procedures or serial X-ray services on the claim.
Indicate the time each service was performed in the electronic claim time field or Item 19 of the CMS-1500 claim form.
Provide a complete, written 'interpretation and report' similar to a specialist report for any interpretation of an X-ray.
For a second interpretation submitted with modifier 77, include documentation explaining why the second interpretation was medically reasonable and necessary (e.g., need for specialist expertise or changed diagnosis).

Submit multiple, identical radiology services on the same claim and use the days/units field when possible to identify multiple procedures.
For multiple identical services performed on the same date by the same physician, append CPT modifier 76 and indicate the time each service was performed in the electronic claim time field or Item 19 of the CMS-1500 form.
The first interpretation of an X-ray furnished to an emergency room patient is generally reimbursable.
A second interpretation by a different physician may be reimbursed if submitted with CPT modifier 77 and adequate documentation shows the second interpretation is medically reasonable and necessary.
When an emergency room physician and a radiologist both interpret the same X-ray, the physicians should coordinate and determine which physician will submit the claim to avoid duplicate billing.
An IDTF must be credentialed and approved by Palmetto GBA provider enrollment to bill Medicare for a specific diagnostic procedure or material.

L33693 — Peripheral Venous Ultrasound

J09

A53252 — Billing and Coding: Independent Diagnostic Testing Facility (IDTF)

J12

L37371 — Electroretinography (ERG)

J12

L35007 — Vestibular and Audiologic Function Studies

J12

L35434 — Oximetry Services

Ask Verity about documentation requirements, denial risks, or coverage in your state.