HAP Radiology Billing and Coding Blog

A Review of the ACR’s Comments On The Medicare Physician Fee Schedule Proposed Rule For 2019 on September 25, 2018

The American College of Radiology (ACR) does a very thorough job of reviewing and commenting on proposed federal legislation such as the annual changes to the Medicare Physician Fee Schedule (MPFS).  Their 59-page letter of September 10, 2019 to Seema Verma, Administrator 
of the Centers for Medicare & Medicaid Services (CMS), is available on the ACR website for radiologists to review in detail. 

Categories: radiology reimbursement, MPFS, radiology

How the Proposed Medicare Fee Schedule Changes Will Impact Radiology Practices on August 28, 2018

CMS, the Centers for Medicare and Medicaid Services, is constantly on the lookout for procedure codes that it feels do not reflect the current cost or complexity of practice in their valuation.  The annual Medicare Physician Fee Schedule (MPFS) rule modifies many codes with varying degrees of impact to radiology practices. 

Categories: radiology reimbursement, interventional radiology, MPFS, radiology

The Future for Radiologists in the QPP on July 25, 2018

Recently reported developments in federal health care policy could change the direction radiologists are taking to maintain maximum Medicare reimbursement. 

Categories: radiology reimbursement, medicare, medicare reimbursement, Quality Payment Program, radiology, QPP

Radiology Documentation Guidelines for Optimized Coding and Reimbursement on May 18, 2018

In radiology, like all other medical specialties, proper documentation is critical to achieving appropriate reimbursement. If the proper terminology is no used or important descriptors are omitted from the radiology report, the physician may not get paid for the services he or she performed.

Categories: radiology reimbursement, physician reimbursement, radiology documentation, radiology

Update on Billing for y-90 Radioembolization Procedures on November 7, 2017

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.

 

Categories: radiology reimbursement, radiology billing, radioembolization, interventional radiology, nuclear medicine, y-90, radiology

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule on July 25, 2017

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 

 

Categories: radiology reimbursement, cms, MPFS, radiology

New Information on the Medicare Rules for Appropriate Use Criteria and Clinical Decision Support on July 24, 2017

New information has been provided by The Centers for Medicare and Medicaid Services (CMS) that will supplement our article An Update for Radiologists on Appropriate Use Criteria and Clinical Decision Support.  We can now update you from the recent release of the “Proposed Medicare Physician Fee Schedule (MPFS) for 2018” and the “Proposed Rule for Quality Payment Program Year 2.”

Categories: radiology reimbursement, clinical decision support, radiology, appropriate use criteria

Successfully Collecting for Imaging Services to Skilled Nursing Facility Patients on July 21, 2017

Patients in rehabilitation facilities sometimes need imaging services that cannot be provided within the facility itself. Imaging centers willingly accept these patients but they can inadvertently fall into a collections quagmire if they aren’t aware of the Medicare rules related to skilled nursing facilities.

Categories: radiology reimbursement, radiology, skilled nursing facilities

Best Practices in Radiology Patient Billing on June 19, 2017

 Maximizing the patient experience is no longer limited to the achievement of clinical success. It is a critical component of the new, broader partnership between provider and patient – one that now encompasses conversations regarding not only service quality and cost, but also places a greater focus on practice billing processes in line with the higher demands inherent to the new patient consumerism trend.  

 

Categories: radiology reimbursement, radiology billing, patient collections

An Update for Radiologists on Appropriate Use Criteria and Clinical Decision Support on May 8, 2017

Radiologists are understandably nervous about the Medicare rule requiring the use of Appropriate Use Criteria and Clinical Decision Support (AUC/CDS) systems. 

Categories: radiology reimbursement, radiology documentation, clinical decision support, CDS

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