Errors while coding in a 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 medical coding and billing in radiology are essential. In this blog, we will discuss about radiology billing and coding.
- Checking for pre-authorization for procedures such as MRI, CT, and ultrasound. Insurance verification is a must.
- Make sure that that your report is as explicit and specific as possible, like anatomic sites, etiology, and severity, as coders can sniff out a fraud.
- Ensure technologists capture patients signs and symptoms and are included in their notes in the RIS/PACS system so that you as the radiologist reference it in your report.
- Radiologists should not forget about even the smaller collection on each CPT code. Even the minimally reimbursed codes while using procedures like single view and two view x-rays can well add to the revenue cycles in the long run.
- The constantly updated CPT handbook is very essential for every radiologist as coding of any new imaging technique requires the provision of one or more procedural (CPT) codes and one or more diagnostic codes, now a necessary prerequisite to their being covered in reimbursement systems.
- Every radiologist should be aware of modifiers and thus help reduce the risk of denials and thus improve audit compliance. Incorrect usage of modifiers in the radiology practice is stated to be the second most reason for reimbursement being lost. The most common modifiers in radiology billing are 26, TC, 76, 77, 50, LT, RT, and 59. The most crucial modifier, no 59, has often been misused. It is basically employed only if no other descriptive modifier is available.
- With the standard processes conducted include Recovery Audit Contractors (RACs) and Comprehensive Error Rate Testing (CERTs), radiologists now need to be aware of the terminologies when exams are being performed.
- Templates employed by radiologists need to be reviewed and updated regularly, especially when changes in equipment, techniques, and/or protocols occur.
- Detailed Documentation is a must by radiologists. ICD-10-PCS codes have three sections devoted to radiology, used for inpatient procedures, so coding of dictation will depend on if the patient was in/or outpatient. Often report codes may differ because the patient can be examined twice. ICD-10-PCS codes for inpatients must be matched correctly with the CPT code for the procedure. If appropriate codes and detailed reporting, such as matching up codes for the diagnosis in the ICD-10-CM code list are in error, reimbursement may be delayed and revenue lost.
Thus it is vital to know your radiology billing and coding in-depth, so as to avoid errors causing revenue loss. Medical Billers and Coders (MBC) is a leading medical billing company providing complete revenue cycle services. To know more about Radiology Billing and Coding services, email us at: info@medicalbillersandcoders.com or call us at: 888-357-3226.
FAQs
1. Why is insurance verification important in radiology billing?
Insurance verification ensures that procedures like MRI, CT, and ultrasound are covered, preventing unnecessary claim denials and ensuring reimbursement for services.
2. How can radiologists prevent coding errors?
Radiologists can prevent coding errors by using explicit and detailed documentation in their reports, capturing all relevant details such as anatomic sites, etiology, and severity.
3. What role do modifiers play in radiology billing?
Modifiers are used to adjust the reimbursement for certain services. Correct use of modifiers, such as 26, TC, and 59, helps reduce denials and ensures accurate reimbursement.
4. Why is it important to regularly update billing templates?
Templates must be updated to reflect changes in equipment, techniques, and protocols to ensure accurate coding and prevent revenue loss due to outdated or incorrect information.
5. How does detailed documentation impact radiology billing?
Detailed documentation, including accurate ICD-10-PCS and CPT codes, is essential to prevent reimbursement delays and revenue loss by ensuring that the correct procedures are properly billed.
