California Code of Regulations
Title 8 - Industrial Relations
Division 1 - Department of Industrial Relations
Chapter 4.5 - Division of Workers' Compensation
Subchapter 1 - Administrative Director-Administrative Rules
Article 5.3 - Official Medical Fee Schedule
Section 9789.17.2 - Radiology Consultations

(1) Only one interpretation of an x-ray procedure shall be reimbursed. This interpretation of an x-ray procedure must directly contribute to the diagnosis and treatment of the patient. The physician must prepare a signed written report of his or her interpretation of the results of the x-ray. The professional component of the x-ray procedure shall be paid using modifier -26. A professional component billing based on a review of the findings of these x-ray procedures, without a complete written report similar to that which would be prepared by a specialist in the field, does not meet the conditions for separate payment of the service.

(2) Reimbursement for a second interpretation shall only be allowed under unusual circumstances (for which documentation is provided), such as a questionable finding for which the physician performing the initial interpretation believes another physician's expertise is needed or a changed diagnosis resulting from a second interpretation of the results of the procedure. This second interpretation shall be identified through the use of modifier "-77".