Medicare Payment Conditions for Radiology Services

Medicare covers diagnostic and radiology services, but these services must be completed or supervised by a certified radiology physician. Both radiology and other diagnostic health services go under a patient’s Medicare Part B coverage. Radiology services are typically under a fee schedule. This means the payment is either the lower billing charge or the Medicare […]

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E&M Billing for Interventional Radiology

A radiology practice that includes interventional procedures has to be up to date on the use of documentation and coding techniques for Evaluation and Management (E&M) services. Since these CPT codes in the 99xxx range are less commonly utilized in many radiology practices, identifying circumstances where E&M services are billable, and then properly documenting and […]

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Benchmarking Financial Performance of Radiology Practices

Benchmarking involves comparing business statistics to historical data or to the same type of data gathered across a wider spectrum. This is only one statistic, or metric, that can be used to evaluate a practice’s performance. In addition to physician productivity, practices often measure their quality of service and financial performance against internal goals or […]

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5 Inefficiencies in Radiology Billing and Coding

Most radiology practices are currently feeling the pinch of deep reduction in imaging revenue and decreased volume. Based on an analysis of the change in imaging volume from Yale’s academic multi-specialty radiology practice, the group saw a 70 percent dip in outpatient imaging since the start of the COVID-19 crisis, including a 50 percent drop […]

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Challenges to Radiology Medical Billing

Radiology medical billing has its own set of challenges. Unlike the rest of medical billing specialties, radiology billing has two components i.e., the professional component and the technical component. While billing for radiology, when a radiologist uses a radiology apparatus, dyes & machines, it must bill it under technical elements, whereas diagnostic results must be […]

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Coding for Treatment Devices in Radiation Oncology

Coding for Treatment Devices  Treatment devices, designs, and construction may be charged during a course of therapy when documentation substantiates multiple volumes of interest/ports, the use of custom-made devices, and/or the necessity of replacement devices. Providers should bill for devices at the beginning of the treatment course and then may bill again later in the […]

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“No Surprises Act” – Impact on Radiologist

The No Surprises Act provides new federal consumer protections against surprise medical bills and it contains key protections to hold consumers harmless from the cost of unanticipated out-of-network medical bills. Surprise billing can arise in both emergency and non-emergency situations and it is observed that 2 in 3 adults are worried about unexpected medical bills. Moreover, […]

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How to do billing for Radiology during COVID?

Radiologists who are practicing in an imaging center or other non-hospital facility have updates available which will potentially allow them to reimburse some of the added costs related to safety precautions taken during the COVID-19 emergency. Medicare will pay under the Medicare Physician Fee Schedule billing for radiology services when beneficiaries obtain services through a […]

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Impact of Radiology Billing Mistakes on Reimbursement

There are many hurdles during the process of radiology billing reimbursement. Claim rejection and postponements are not only disappointing to your imaging center but also showcase the extended timeline inpatient care, idle machines, and wasted physician hours. From the past few years, imaging centers have observed an increase in prior authorization declinations. Furthermore, in some […]

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