HAP Radiology Billing and Coding Blog

When people are referred by their personal physician to a specialist, they usually see the specialist in his or her office for a consultation.  Following the office visit, if the patient and physician deem a procedure to be appropriate, the procedure is scheduled in a facility such as an ambulatory surgicenter or hospital procedure room.  Interventional radiologists, on the other hand, most often see their consultation patients at the time of the procedure in the hospital setting where the procedure will be performed, rather than in their own office.  Changing this approach can yield benefits for the radiology practice, as well as for the patient.

Click here to read our October 2020
y-90 radioembolization article 

Our 2014 article "Interventional Radiology Meets Radiation Oncology – The y-90 Story” focused on the documentation requirements that will assist coders to maximize reimbursement for this complex procedure.  Those documentation tips are still valid today.  This update reviews the 2017 state-of-the-art in coding for y-90 procedures.

Read our 2021 IR billing & coding article

A radiology practice that performs interventional procedures will want to be up to date on the use of documentation and coding techniques for Evaluation and Management (E&M) services.  These CPT^® codes in the 99xxx range are less commonly utilized in radiology practices.  Identifying circumstances where E&M services are billable, and then properly documenting and coding for them, will require a collaborative effort between the interventional radiologist (IR) and his or her coding team.

Click here to read our 2024 code changes update article. 

The annual cycle of revising codes in the Current Procedural Terminology (CPT)® has been completed with the issuance of the Medicare Physician Fee Schedule (MPFS) Final Rule for 2017. For diagnostic radiology, the changes this year are in mammography bundling, ultrasound screening for abdominal aortic aneurysm, and fluoroscopic guidance.  Interventional Radiology (IR) will also be subject to bundling and other rearranging of codes for certain procedures.  Finally, there are new codes that have been created to describe procedures previously unlisted, which generally will improve reimbursement for those procedures, and codes deleted from use, which will return the affected procedures to the ‘unlisted’ category.

In our two recent articles we covered the effect of changes to codes in the Current Procedural Terminology¹ (CPT) for diagnostic radiology and radiation oncology. Now we turn our attention to CPT code changes for 2016 that affect interventional radiology (IR).  As before, our analysis focuses on the effect those changes will have on practice revenue.  Each practice’s experience will vary based on the volume of procedures that use the affected codes, and a volume-weighted analysis of the entire Medicare fee schedule is recommended to gain a complete understanding of the impact to the practice.

In this blog article that continues our series on how to optimize radiology documentation for maximum reimbursement potential, we address the two most important questions specific to imaging guidance in interventional radiology. Imaging guidance is more and more frequently bundled with the primary interventional procedure, especially with the new CPT[i] codes proposed for 2016. It is, however, still separately billable in certain cases. Regardless of whether it is bundled or not, the radiologist’s documentation for the procedure requires certain elements that thoroughly describe the guidance methods and results. Here are the answers to the two most important questions for your radiology practice to consider.

The annual cycle of revising codes in the Current Procedural Terminology¹ (CPT)® has been completed with the issuance of the Medicare Physician Fee Schedule (MPFS) Final Rule for 2016, and radiology is one of the areas most affected by the changes.  The traditional radiology section of codes, 70010 – 79999, has 60 additions, revisions or deletions and there are even more when the Interventional Radiology (IR) surgical codes are considered.