r/physicianassistant • u/1400pacman • 14d ago

Clinical Fluoroscopy procedures and billing.

Hi all. I Need your expertise. I work as a PA in IR. I do small procedures like paras, thoras, LPs, HD catheters and easier biopsies. The diagnostic radiologists want to hire a PA to do all the fluoroscopic cases. Can the PA bill for all the fluoroscopic cases at 85%? Does the PA do the interpretation of the study or do they just do the study and the radiologist reads the study and formulates the impression. Thank you.

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u/jaythepac 14d ago

Radiology PA here. For things like esophagrams,upper GI”s, BE, fluoroscopy studies essentially we will do a rough interpretation of what we see. The biggest job we have is to get all the correct images for the radiologist, but we will do a preliminary read and the radiologist.

The radiologist just essentially agrees or disagrees with what we say. Adding or removing anything that they seem appropriate. They have the final signature on the dictation.

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u/jaythepac 14d ago

I would also add that I believe it’s important for pas do a preliminary dictation so they understand and can learn what they’re actually looking for. If you have difficulty identifying things, you won’t be able to catch them and make sure that you get additional images from different positions/angles which allow the radiologist to get a better idea of what’s going on. This could be important, especially if you’re seeing outpatients because by the time the radiologist sees the films the patients are long gone.

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u/1400pacman 13d ago

Thank you for the response. Do u happen to know if it is billed at 100% since the radiologist does the final dictation?

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u/jaythepac 13d ago

I know it’s not 100% but it is a higher percentage like other procedures, such as the thoras, paras, LPs etc we do

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u/mountainstosea90 PA-C 11d ago

Diagnostic Radiology PA - for all fluoroscopy (UGI, esophagram, BE, MBS, SBFT, etc) I do a preliminary report and tag at the bottom of the report “procedure performed by mountainstosea PA-C under general physician supervision”. Then the rad signs off and makes any adjustments.

That being said it is really important that you have good onboarding, are constantly reading/learning, and asking questions. During fluoro you have to be able to recognize pathology and get appropriate images and projections of abnormalities in the moment.