Radiology field is often sifted with complications when medical billing charges are charged for various encounter types. The recent changes in the healthcare environment have necessitated that a medical billing team must have a dedicated and prompt follow through on denials and no claim responses.

The range of patient care issues provided by Radiology is wide and varied. Errors while coding in radiology environment can be expensive in the long run, given the denial rates. In order to get as near to perfection, certain basic knowledge when coding and medical billing in radiology is essential. Hence it is important to keep up with the latest development in Radiology medical billing.

What New Developments In Radiology Suggests:

The healthcare industry has changed drastically in the last decade, and most especially in the last year which has an entirely new set of challenges; especially for radiologists.

Gone are the traditional Radiologists days; the treatment and care is not limited to just reading an X-ray. Radiologists cover many areas of medical care including Radiation Oncology, Pain Management, and Interventional Radiology.

There are a number of new codes and guideline revisions will be implemented for 2017

  • Proposed are the changes to Flouroscopy, CAD and mammography, as well as Ultrasound screening for Abdominal Aortic Aneurysm.
  • Interventional Radiology will see new codes bundling some of the services they do for e.g. Open and Percutaneous Transluminal Angioplasty PTA.
  • Pain Management will see changes to Epidural injections.
  • Include the suitable injection code when billing your diagnostic arthrography.
  • Injection procedure for hip arthrography; without anesthesia is billed.
  • The arthrogram must be diagnostic in nature to be reportable with these codes.
  • Be sure documentation shows medical necessity and findings are documented.
  • Be sure to read the entire description of the CPT code you are using. You may miss laterality or inclusion of another area.
  • Radiologic examination CPT codes 73501-03 and 73521-23 are the codes for unilateral and bilateral hip examinations respectively, but you need to read carefully till the end of each of these codes to make sure that the pelvis is included when performed.

What Radiology Medical Billing Has To Know:

Implementation of ICD-10 codes has played an important role over the past year, according to industry experts at RSNA 2016.

The implementation of ICD-10 occurred approximately one year ago, and despite heightened concern prior to the shift, one year later the disruption has been minimal.

Importance of this new coding mechanism compared to its predecessor. ICD-10 diagnosis codes are able to translate relevant clinical information into data used for research – Not just a software update.

Strong Impact on Quality - ICD-10

  • It is to ensure that proper ICD-10 usage let for both hospitals and physicians to get paid and steers quality improvement.
  • Radiologists need to communicate their own interactions with patients. Reports should be robust and contain the story of why the patient was there, what was done to them, and what was diagnosed.
  • The Quality Payment Program - QPP formerly known as MACRA went into effect from January 1, 2017, furthering tying radiologists' reimbursement to quality metrics that can be relayed through diagnosis code.
  • Codes also offer data rich opportunities to look for variances within practices and departments as well as improvement opportunities that tells patient's story more accurately.

Get What You Pay for in Radiology Billing

While technology and coding efforts have allowed physicians to create robust reporting while managing a heavier workload, technical automation and the use of third party offshore vendors for medical billing has come to rescue in reducing cost and has become a growing trend.

Outsourcing to professional Radiology medical billing vendors is another low-cost option for medical billing. Language barriers, lack of follow up on worker's comp and patient calls, and errors regarding refunds and credits, can be taken care of when Radiology medical billing and coding is outsourced.

Internal audits and mini audits throughout the year should be implemented to manage those situations much more closely.

Published By - Medical Billers and Coders
Published Date - Mar-17-2017 Back

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