Imaging and X-Ray Billing Errors: What to Watch For
Imaging bills for X-rays, MRIs, and CT scans often contain errors. Learn to spot technical vs professional fee issues and save $200-$5,000.
Potential savings: $200-$5,000
Medical imaging, including X-rays, MRIs, CT scans, and ultrasounds, represents a significant portion of healthcare costs. Imaging bills are particularly complex because they often involve separate charges for the technical component (the equipment and technician) and the professional component (the radiologist's interpretation). This split billing creates numerous opportunities for errors and overcharges.
What Is Imaging and X-Ray Billing Errors?
Imaging billing uses CPT codes to describe both the type of imaging study and how it was billed. Most imaging codes have three billing options: the global code (both technical and professional), the technical component only (modifier TC), or the professional component only (modifier 26). When both the facility and the radiologist bill separately, they should use the TC and 26 modifiers respectively. Billing the global code plus either component is a common error.
Common Billing Errors
The facility bills the global imaging code (which includes both technical and professional components) while the radiologist also bills the professional component separately. This results in the professional interpretation being billed twice.
CPT 71046 (global chest X-ray) + 71046-26 (professional component)Billing two separate unilateral imaging studies when a bilateral code exists and should be used. For example, billing a right knee X-ray and left knee X-ray as two separate studies instead of using the bilateral modifier 50 or the bilateral code.
CPT 73560-RT + 73560-LT vs 73560 x2 (bilateral knee X-ray)Being billed for repeat imaging studies that were performed because the first set was poor quality or the technician made an error. If the imaging needed to be repeated due to a facility error, you should not be charged for both studies.
Billing a more complex imaging study than what was performed. For example, billing a CT scan with contrast when only a CT without contrast was done, or billing an MRI with and without contrast when only one series was performed.
CPT 74177 (CT abdomen with contrast) vs 74176 (without contrast)How to Spot These Errors on Your Bill
- 1
Check if both a global imaging code and a separate professional component (modifier 26) appear on your bills.
- 2
Look for bilateral modifier 50 misuse or two unilateral studies when a bilateral code should have been used.
- 3
Verify the specific type of imaging study matches what was performed (with vs without contrast).
- 4
Ask for the radiology report and compare the study described against what was billed.
- 5
Check if you received separate bills from the imaging facility and the radiologist for the same study.
Frequently Asked Questions
Why do I get two bills for one imaging study?
It is normal to receive two bills for imaging: one for the technical component (the facility that owns the equipment) and one for the professional component (the radiologist who interprets the images). However, check that the combined charges equal the global code amount, and that you are not being billed the global code plus a separate professional fee.
Can I choose where to get my imaging done?
In most cases, yes. Independent imaging centers are often 40-70% cheaper than hospital-based imaging departments for the same studies. Ask your doctor for a prescription and shop around. Make sure the facility is in your insurance network and has accreditation.
What is the difference between TC and 26 modifiers?
Modifier TC (Technical Component) indicates the charge for the equipment, facility, supplies, and technician who performed the imaging study. Modifier 26 (Professional Component) indicates the charge for the physician who interpreted the results and wrote the report. Together, they equal the global (complete) service code without any modifier.
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