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Coding Changes that Might Affect Radiology Billing in 2015

January 21, 2015

The year 2015 has brought various coding, compliance and revenue changes and challenges for radiologists. Some changes are small whereas some will have a huge impact on the practice’s revenue cycle. Some of the coding changes that will affect radiology billing in 2015 are as follows:

  • Breast Imaging
    Is your online medical billing system updated? Have you been using certified billers and coders? It is important for chiropractor offices to use medical billing programs that can inform providers about the changes in payer claim reimbursements. Claims submitted by the billing department should fit the insurance company’s system or else it will lead to denied claims and delayed payments.
    As per the 2015 Medicare Physician Fee Schedule Final Rule, codes for diagnostic tomosynthesis (77061 and 77062) will not be valid for Medicare billing. Providers will be required to report this service to Medicare using a new HCPCS code +G0279 which cannot be reported as a stand-alone service. The codes 77061 and 77062 may not be reported to payers who accept the former codes along with the regular screening mammography code, i.e. 77057. This will pose as a challenge in reporting screening and diagnostic studies on the same date of service. Even though there is a new procedure code for this technology, it is not necessary that payers will provide separate payment for the same.
  • Myelography
    Two myelogram injection codes have been revised for 2015 and four new codes have been included for myelogram contrast injection and imaging. The existing myelogram imaging codes have not been deleted for 2015. There is some concern related to the reporting and performance of traditional myelography in relation with CT studies of the spine. The supervision and interpretation of myelography shouldn’t be reported without the referring physician requesting an X-ray myelogram.
  • Vertebroplasty, Sacroplasty and Vertebral Augmentation
    For 2015, the existing vertebroplasty codes have been deleted and three new codes added. When performed at the same level, all of the vertebroplasty, sacroplasty and kyphoplasty codes include bone biopsy. The existing vertebral augmentation codes have been deleted and three new codes added. Even Category III sacroplasty codes have been revised for including bone biopsy and imaging guidance.

Minor Changes to Radiology Coding

Apart from the above mentioned changes, several other changes will impact the coding and billing for radiologists. For instance, note the following changes in the codes:

  • Tumor ablation code has undergone revision
  • Three existing codes for arthrocentesis have been revised
  • A new code has been added for physician planning that requires approximately 90 minutes for fenestrated endovascular aortic repair (FEVAR)

Radiology practices will also have to prepare for ICD-10 coding system, which is scheduled for October 01, 2015. The new coding system will be more detailed and it will require radiologists to improve their documentation skills to ensure error-free coding and claims submissions. In order to get timely payments, many providers have started outsourcing their radiology billing services to a third party. By seeking assistance from billing companies like MedicalBillersandCoders.com, radiologists have been able to ensure error-free coding, timely claims submission, follow-ups with payers and compliance with healthcare reforms.


Category : Best Billing and Coding Practices