HAP Radiology Billing and Coding Blog

Evaluation and Management Coding and Billing for Interventional Radiology on March 11, 2021

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®[i] 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 coding for them, will require a collaborative effort between interventional radiologists (IR) and their coding team.

Categories: interventional radiology, IR coding, interventional radiology billing, E&M, evaluation and management

Coding Changes That Will Impact Radiology Practices In 2021 on January 6, 2021

The big news in Current Procedural Terminology[i] (CPT)® revisions for 2021 is the overhaul of the Evaluation and Management (E&M) section, reducing documentation requirements, and introducing new rules for determining the level of coding. These changes will affect interventional radiologists and radiation oncologists more than they will the day-to-day work of diagnostic radiologists. First, we will review the other non-E&M code changes affecting diagnostic and interventional radiology for 2021.

Categories: radiology coding, interventional radiology, IR coding, CPT codes, radiology, diagnostic radiology

Current Coding and Documentation for y-90 Radioembolization Procedures on October 30, 2020

The treatment of liver tumors using yttrium-90 (y-90) radioembolization brings unusual challenges for interventional radiologists (IR). Documentation of treatment planning, radiation dosimetry calculations and placement of radioactive sources are not usually a familiar part of their lexicon. It is these unfamiliar disciplines, along with more comprehensive Evaluation and Management (E/M) visits, that set this procedure apart from the more routine IR cases.

Categories: interventional radiology, y-90, interventional radiology billing

Medicare Announces Prior Authorization Requirement on July 23, 2020

Radiologists who perform venous ablation in a hospital outpatient department are now required to obtain prior authorization before performing such services on Medicare patients.  This new requirement became effective for services performed on or after July 1, 2020, and physicians were notified by letters from the Centers for Medicare and Medicaid Services (CMS) late in June.  The prior authorization requirement was included in the 2020 Hospital Outpatient Prospective Payment System (HOPPS) Final Rule, and encompasses the following procedures that might be performed by interventional radiologists:

Categories: radiology reimbursement, radiology billing, interventional radiology, cms, interventional radiology billing

Update on Interventional Radiology Coding and Billing on May 30, 2019

Read our 2021 IR billing & coding article 

 

Proper coding of physician services is essential to efficient billing and the optimization of reimbursement from payers, including commercial and governmental entities.  The CPT® codes issued by the American Medical Association (AMA) to describe physician procedures are supposed to be recognized as standards, but in practice they are not accepted equally by all payers.  One example is CPT codes in the range 99241-99255 that describe consultation services.  These are most often used by interventional radiologists, as described in our article Coding and Billing Considerations in Interventional Radiology.

Categories: radiology billing, medicare, medicare reimbursement, interventional radiology, radiology, interventional radiology billing

The Value of PICC Lines for Interventional Radiologists on April 16, 2019

Interventional radiologists are often called to perform peripherally inserted central venous catheter (PICC) prodecures.  Recent coding and policy changes bundle all imaging guidance and the confirmation of final placement into a single CPT® code.  Let’s review the financial implications of those changes.

Categories: radiology reimbursement, medicare reimbursement, interventional radiology, PICC

Understanding The Valuation Changes In The Final Medicare Fee Schedule For 2019 on February 27, 2019

Our review of the proposed 2019 Medicare Physician Fee Schedule (MPFS) showed that 201 Professional Component (PC) codes and 213 Global codes were to be decreased by at least 1% in the Diagnostic Radiology 70000-series of CPT codes.  In the final MPFS, only 46 PC codes were reduced by 1% or more, but 280 global codes were reduced by at least 1%.  The number of codes expected to increase in payment did not change as dramatically, but in both PC and Global billing fewer codes were increased than we expected.  Here are the details:

Categories: radiology reimbursement, interventional radiology, MPFS, radiology, diagnostic radiology

Researchers Asked for A Follow-Up System, And We’ve Got It on February 13, 2019

A recent study aimed at calculating follow-up recommendations in radiology reports and comparing the efficacy of various methods to identify patients in need of follow-up suggests the usefulness of technologies that can take action on those recommendations.  The study that was conducted by Dr. Emmanuel Carrodeguas and his colleagues, published on December 29, 2018 in the Journal of the American College of Radiology and reported by AuntMinnie.com, concludes in part that “Automatic identification of follow-up recommendations could have wide implications for establishing and timely performance of collaboratively developed follow-up care plans for actionable findings in radiology reports to improve quality and experience of care for patients.”

Categories: interventional radiology, clinical analytics, IVC filters, diagnostic radiology, follow-ups

Coding Changes That Will Impact Radiology Practices In 2019 on January 2, 2019

Click here to read our 2021 code changes update article. 

 

Each year there are revisions of Current Procedural Terminology[i] (CPT)® that will impact the way radiology practices code their procedures and, ultimately, how they are reimbursed for those procedures.  The majority of CPT code changes in radiology for 2019 are for Interventional Radiology procedures.  Those that pertain to diagnostic radiology are in ultrasound, MRI, and nuclear medicine.  We’ll cover the diagnostic codes first, and then go into detail on the interventional coding changes.

Categories: medicare, medicare reimbursement, interventional radiology, MPFS, CPT codes, radiology, diagnostic radiology

New Study Supports the Value Of IVC Filter Tracking Systems on October 3, 2018

A study reported in the September 2018 American Journal of Roentgenology concludes, “A semi-automated approach to tracking patients with IVC filters can facilitate care coordination and clinical decision-making for a device with known potential complications.”  The study followed 293 IVC filter recipients over a 6-month period, and found that the use of a tracking system improved the filter retrieval rate from 23% to 34% over the same period of the previous year. 

Categories: interventional radiology, incidental findings, IVC, IVC filters

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