Radiology is a medical specialty that uses technology in the form of X-ray, Computed Tomography (CT), CT Angiography (CTA), Magnetic Resonance Imaging (MRI), MR Angiography (MRA), Ultrasound, Nuclear Medicine, and Positron Emission Tomography (PET) scans to diagnose as well as treat various health conditions.
Submission of claims for radiology services can be complicated as both private and federal payors scrutinize both diagnostic and interventional imaging services according to their own rules. So billers have to be knowledgeable about payors' rules and regulations to have claims processed without denials.
The American College of Radiology practice guidelines states that a complete radiology report is mandatory to support proper code assignment and optimal reimbursement. Documentation is therefore vital in radiology billing.
Payors may ask for medical records that support medical necessity before they pass a claim. This may include the patient's medical history, physician consultation reports, discharge summaries, and radiology reports. Medicare guidelines for radiology billing require the medical necessity for claims processing.
Imaging reports should also be complete and contain the following information.
- Exam name
- Clinical indication/reason for the exam
- Description of exam, sequences, and technique
- Conclusion and recommendations, if indicated
- Physician's signature
Documentation is crucial while submitting claims to both private payors and state agencies.
Our billers and coders are certified and are continuously trained in all aspects of radiology billing. They can code and bill accurately for radiology services with
- Ability to review clinical issues and CPT, ICD-10 and HCPCS coding guidelines for interventional/non-interventional radiology
- Know differences between diagnostic radiology codes and therapeutic interventional radiology codes
- Can review coding guidance for modifier usage with interventional radiology procedures
- Able to code challenging case scenarios
While coding for radiology, understatement of services could mean lesser reimbursement for a facility. And over-coding could result in compliance issues. Further, with all the changes in codes and rules, coding can become complicated.
All the above-listed issues can be resolved by partnering with a reputed medical billing company like Bristol Healthcare Services. We have certified coders who work with commitment, attention to detail, and have in-depth knowledge of the coding system. We offer customized and affordable radiology medical billing and coding services. Our turnaround time is between 12-24 hours. We process over 3 million Radiology reports.
With us by your side, your radiology billing collections are consistent resulting in good cash flow for you.
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