Haw. Code R. § 16-23-111 - 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 insurer shall 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 on machines with a current certification by the department of
health.
(c) Where contrast x-ray
examinations are performed, fees shall include the usual contrast media. When
special trays or materials are provided by the health care provider, 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 health care provider
actually performing the service.
(e) 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.
(f) 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.
Notes
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