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How Are The Current CPT Modifications In Radiology Practice Affecting The Diagnostic Procedures?

July 14, 2017



How-Are-The-Current-CPT-Modifications-In-Radiology-Practice-Affecting-The-Diagnostic-Procedures-?

As we hit the mid-year, a recap of things that just passed by in the past six months will be reflected in the upcoming six months. Since 2017 began the nations was first struck with the pleasant (and for some unpleasant) news of Donald Trump getting elected to the country highest post. Then the turmoil of refugees began, and businesses in North America, especially the Healthcare companies are on a catch-22 situation as what the future of claims holds onto them.

As far as healthcare facilities are concerned they have to face a different set of challenges, and that too each year, which is CPT codes modifications that duly transforms their treatment procedures into reimbursements. However, the most important entity in this cycle is the medical billing and coding personnel that have to be agile enough to accurately put down all the codes with latest modifications.

CPT modifications in Radiology Practice Affecting the Diagnostic Procedures

The yearly cycle of updating codes in the Current Procedural Terminology (CPT) has been already implemented with the issuance of the Medicare Physician Fee Schedule (MPFS) Final Rule for 2017. For diagnostic radiology, the developments this year are in mammography, ultrasound screening and fluoroscopic guidance.

Interventional Radiology (IR) will likewise be liable to bundling and other modifying of codes for specific methods. However, there are new codes created to describe procedures previously unlisted, which will generally improve the reimbursement for those procedures, and codes deleted from use, which will return the affected procedures to the 'unlisted' category.

Below are some Diagnostic Radiology lines that will have the new CPT codes in use, for accurate billing and coding used for reimbursement purposes.

Mammography

The coding for mammography has been streamlined, with the deletion of separate added codes for computer aided identification (CAD). Do note that CMS chosen to hold the G-codes at present at least for a year. A change to the new CPT codes that are as of now characterized will be coming definitely in 2018. A few practices may have prepared for the change to CPT codes that was expected for 2017.

Fluoroscopy

The utilization of two existing codes for fluoroscopic guidance has been overhauled. They will be utilized as an addition to coding for a primary procedure and incorporated into global period for essential codes. Before the new CPT modification medical billers and coders used them as independent codes that were not subject to the global period concept. The RVU values for these codes were revised upward for 2017, which will bring about higher reimbursement for them.

Moderate (Conscious) Sedation

The utilization of two existing codes for fluoroscopic guidance has been overhauled. They will be utilized as an addition to coding for a primary procedure and incorporated into global period for essential codes. Before the new CPT modification medical billers and coders used them as independent codes that were not subject to the global period concept. The RVU values for these codes were revised upward for 2017, which will bring about higher reimbursement for them.

Angioplasty

Transluminal swell angioplasty, regardless of whether percutaneous or open, is currently bundled with the related radiologic imaging administrations in one code, and separated by whether performed on an artery or vein.

In conclusion, we can advise the Radiology facilities to get in conjunction with the new CPT codes, or align their charging process with an experienced Radiology medical billing and coding company to optimize the new codes accordingly and present facilities with a reimbursement rate to the last dollar.

 

Category : Best Billing and Coding Practices