HAP Radiology Billing and Coding Blog

Medicare’s required changeover to ICD-10 diagnosis coding has shed more light than usual on a topic that requires constant diligence by radiology practices. Regardless of the payer being billed, good procedure coding and diagnosis coding are a must – and the source material for that coding is the documentation found in the radiologist’s report of the imaging examination.

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Categories: radiology reimbursement, radiology documentation, breast imaging, CT imaging, 3D reconstruction, ultrasound, tomosynthesis, DBT

The use of 3D reconstruction CT scans is common in radiology practices for various exams. Understanding when and how to document 3D recon CT is crucial for proper billing. In some cases it is a minimum requirement in order to bill for the exam that was intended, while in other cases it will garner extra reimbursement. Either way, it must be specifically documented in order for coders to properly bill for the procedures. In this article we will review the financial reasons for providing good documentation, identify when 3D reconstruction is required and when it is an additional charge, and finally understand the documentation requirements that will provide the maximum reimbursement in these various circumstances.

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Categories: radiology documentation, CT imaging, 3D reconstruction, CT angiography