Billing and Coding: Repeat X-ray or EKG Interpretations by Same or Different Physician

Medicare generally pays a single interpretation and written report of an x‑ray or EKG for an emergency room patient; brief reviews or minimal notations are considered part of the E/M and are not separately payable. A second interpretation is payable only under documented unusual circumstances (e.g., questionable finding or changed diagnosis) when billed with modifier -77, and repeated same‑day studies by the same physician should use modifier 76.

"Pay for a single interpretation and written report of an x‑ray or EKG furnished to an emergency room patient when that interpretation directly contributed to the beneficiary's diagnosis and treatment."

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