HAR §12-15-54. Radiology services

(a) Taking of anterior- posterior (A-P), lateral, and oblique x-rays shall be discretionary for one hundred twenty days following the initial treatment and may be allowed without authorization. Prior authorization from the employer must be obtained for x-rays subsequent to the initial one hundred twenty days of treatment. (b) Diagnostic tests and x-rays shall be taken, reported, and marked for identification and orientation in accordance with the accepted standard of radiologic practice. X-rays shall be taken with machines with a current certification by the department of health. (c) Where contrast examinations are performed, fees shall include the usual contrast media. When special trays or materials are provided by the physician, rather than by the hospital, an additional charge is warranted. (d) Injection procedures, including major surgery, for the purpose of performing needed radiological studies, are covered in the section on surgery. The fee shall be paid to the physician actually performing the service. (e) X-rays shall be furnished upon request to the director or the employer and shall be returned upon review. When requested by the director or employer, the health care provider shall make any x-rays in the health care provider’s possession available to the consulting physician. The injured employee may carry the x-rays to the consultation. When there is a change in attending physicians, the x-rays or copies of good quality shall be made available to the new attending physician at no charge. Refusal of a health care provider to provide the x-rays upon request at any time shall result in nonpayment of the fee or credit to the employer’s account for the radiological study. (f) Fees shall include both the technical and professional components. In the absence of any prior agreement between a radiologist and a hospital or other facility furnishing technical radiology services, the professional component shall be thirty-five per cent of the scheduled radiology fee. The technical (-TC) and professional (-26) components may be billed separately using the appropriate modifiers as indicated by Medicare. Billings for x-rays are not reimbursable without a report of the findings. (g) Radiotherapy includes the use of x-ray and other high energy modalities (betatron, linear accelerator, etc.), radium cobalt, and other radioactive substances. Fees for therapy include follow-up care, and concomitant office visits, but not concomitant surgical, radiological, or laboratory procedures. [Eff 1/1/96; am 1/1/97] (Auth: HRS §§386-26, 386-72) (Imp: HRS §§386-21, 386-26, 386-94) 26