Reduce Coding Errors with Accuracy in Radiology Billing and Documentation

Reduce Coding Errors with Accuracy in Radiology Billing and DocumentationICD-10 deadline may have shifted to 2015 but in order to ensure error-free coding and timely reimbursements, radiologists have to enhance the documentation. Apart from being robust, documentation must also contain sufficient information for assigning accurate and detailed ICD-10 codes.

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If physicians in a radiology practice are not documenting to the highest levels of details, it will result in coding errors and denied payments. It can also lead to costly litigation and decrease the efficiency of providers.

  • Radiologists lose a significant percentage of their income due to incomplete documentation and under-coding
  • In order to reduce revenue loss and enhance the quality of radiology reports, they need to perform structured reporting
  • An effective solution is required to identify, address and prevent deficiencies in documentation right from the point of care
  • Documentation should be structured with encoded clinical data. It should be complete and compliant

Providers can enhance patient outcome and reimbursement through complete and properly coded radiology documentation. This should be combined with insightful reporting, performance monitoring and organizational efficiency. Whether or not a radiologist’s documentation is ready for ICD-9 and ICD-10 coding can be ensured through the below mentioned steps:

Monitoring Coding Regularly

Once you have identified the documentation gaps, you need to need to run monthly reports on diagnosis code usage and conduct chart reviews randomly to see if there have been improvements in the process. This will ensure proper monitoring too.

Reviewing Medical Necessity Denials from Payers

You must also conduct a review of current medical necessity denials in order to know the concern areas that need rectification before ICD-10 implementation. Identify which insurance payer has the maximum number of medical necessity denials and then review radiology reports to understand whether an unspecified code or insufficient documentation has caused this denial.

Analysis of the frequency of unspecified code is also essential to understand what is resulting in the unspecified code. For instance, it can be the fault of your coder if the radiology report had the specific information but with an unspecified code. This will help to pinpoint whether it resulted from lack of the coder’s knowledge or was simply a documentation issue.

Requests sent from coders to radiologists should be tracked because this will help in finding out how often medical coders at the radiology practice requested clarification or asked for more documentation to assign the proper code.

Physicians should ensure billing and documentation errors are being taken care of or payments will be denied. However, due to lack of time, money and resources, many radiologists prefer outsourcing their billing needs to companies like MBC has the largest of consortiums of certified coders and billers who not only handle your RCM well and help get you paid on time by making claims submission, follow-ups, denial management, and offer assistance in identifying and improving gaps in documentation. They offer effective HIPAA-compliant billing solutions.