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.
Categories: radiology reimbursement, radiology coding, interventional radiology, MPFS, MRI
When a physician is performing an interventional procedure valued in the range of $4,000 – $6,000 for the professional component, attention to thorough and accurate documentation is a requirement for maximal reimbursement. Each case presents its own individual set of circumstances and a well-constructed operative report will tell the story of the case step-by-step. Each artery or branch into which a catheter is placed for diagnostic imaging or intervention is assigned a separate CPT code, and so the operative report must describe with specificity each catheter placement. When these descriptions are in a logical, sequential order, certified coders say that this allows them to better understand every aspect of the case so they can then accurately identify and apply up to 45 CPT codes to maximize reimbursement for it. A descriptive evaluation of each artery supports payment of the codes that are submitted for reimbursement.
Categories: radiology reimbursement, radiology billing, physician reimbursement, radioembolization, interventional radiology, nuclear medicine, y-90
