Billing Part B Radiology Services and Other Diagnostic Procedures

50 - Billing Part B Radiology Services and Other Diagnostic Procedures (Rev. 1, 10-01-03) Acceptable HCPCS codes for radiology and other diagnostic services are taken primarily from the CPT-4 portion of HCPCS. Payment is the lower of billed charges or the fee schedule amount. In either case, any applicable deductible and coinsurance amounts are subtracted from the payment amount prior to payment. Coinsurance is calculated on the Medicare payment amount after the subtraction of any applicable deductible amount. Additional instructions for coverage, billing, payment, and specific instructions for the services listed below are found in the Medicare Claims Processing Manual, Chapter 13, "Radiology Services": • Contrast material other than low osmolar contrast material (LOCM) for radiology; • LOCM; • Radiopharmaceuticals; • IV Persantine; • Transportation of equipment; • Position Emission Tomography (PET); and • Adenosine.