Healthcare Billing System: Tips to Improve Medical Billing for Radiology

Radiology is one of the core components of the medical healthcare industry and thanks to the latest advancements because of surging technologies, the field of radiology is growing more rapidly than ever.

The science of radiology is all about dealing with high-emitting radiation and X-rays, which are mandatory for the diagnostics and treatments of any kind of disease. This is an expensive side of the medical industry and the medical billing for radiology is also surging rapidly, becoming out of the reach of patients because of the heavy dent in their pockets.

Medical billing for radiology is not the only challenge faced by this sector of medical healthcare. The reduction in reimbursements and the rapidly increasing infrastructure expense have also contributed to the expensive medical bills. As a result, this has made the lives of radiologists challenging because the industry keeps on evolving.

These advancements have led to new additions to the medical billing for radiology in the form of new CPT codes which demand immense attention.

Radiology medical billing is different from other medical sectors as it comprises two components: the technical component and the professional component.

The technical component registers the usage of apparatus, radiology machines, and dyes by the radiologists. On the other hand, the professional component of the medical billing for radiology comprises the radiologist’s services where the person responsible interprets the results and diagnosis of the disease and ailment.

Tips to make medical billing for radiology more comprehensive

Here are some of the tips about how to make the medical billing of radiology more comprehensive and cohesive for the patients and the physicians. Let’s have a look:

Reports must meet the requirements

Reports must meet the requirements

The final billing report must be made according to the guidelines and the requirements dictated by the radiology fraternity. The report must contain:

  • Study name (heading)
  • Sequenced name of views
  • Findings
  • Reason for examination
  • Clinical indication
  • Synopsis
  • Conclusion
  • Signature of the physician
  • Attached are films that are the diagnostics

Compile the technical and professional components separately

A lot of radiology procedures require both the professional and technical sides. Therefore, it is the mandatory requirement of radiology that the coder must code the report for the technical and professional components separately.

For instance, if a radiologist examines two-view X-rays of the chest in a hospital, then the report must include radiologic examination, chest, frontal and lateral, 2 views with help of modifier 26 – code 71020.

If any kind of supplies or technical apparatus was used by the radiologist from his own office or the equipment which was used to conduct the x-ray was personal belonging to the radiologist then the report will not have the mentioning of modifiers.

Documenting only the number of views

The number of views means the basic requirements of the codes that need to be reported in the final billing. If the department of radiology witnesses “standard views” of the number of views sent by the patient – then they cannot be recorded in the bill and can’t be used for the sole purpose of medical billing.

The medical report must itself administer the final number of views. It is the responsibility of the coder to count all the number of views and from that list select the corresponding codes that need to be added to the final medical bill.

For instance, an examination of a knee joint has to be reported with the help of four different codes of CPT, this is reported as radiologic examination, the knee will be having more than 4 views code no 73564.

Documentation for the exam should be completed

Now, if the physician does not mention “four views” but documented it differently stating “AP, two obliques and one lateral view then this is also acceptable for medical recording” but if the physician only stated that the knee was viewed multiple times then it will not correspond with the CPT code and will create confusion for the medical billing.

Therefore, it is immensely important for the physician to cooperate and refer to exactly what the code is asked for/these kinds of diagnostics can cause problems in the long run creating confusion among the patient and the physician therefore it is important that the physician mentions the exact number of views instead of dictating the medical terms of the disease and also report according to the codes for the services he has provided.

Documentation for the exam should be completed

Medical diagnostics like ultrasounds require image documentation. For instance, the study of the retroperitoneal region requires strict documentation for coding to complete the billing and final exam.

When a doctor has to conduct a complete exam of an abdomen this means that he has to conduct an abdominal ultrasound and real-time image documentation with the code of 76700. This will include the detailed documentation of the gallbladder, liver, pancreas, bile ducts, kidneys, spleen, inferior vena cava, and abdominal aorta.

If any of the above-mentioned organ’s anatomy is left unattended and is not documented that this will not be a complete exam and a different code will be referred.

Therefore, it is very important that if the code is used for a complete exam, then a complete exam must be conducted to keep transparency in the final medical billing.

Never forget supplies

The radiopharmaceutical supplies are different from the normal nuclear medicine kits. Mostly, the hospitals and the nuclear medical organization have separate kits of radiopharmaceutical supplies and they should be mentioned in the final bill separately with their designated codes.

Final Words

The medical billing for radiology is a tricky part of the radiology sector of medical healthcare. It requires immense attention so that there are no errors and mistakes which need to be addressed later. The medical billing if done right will assist the radiologist as well as the patient

The transparency in medical billing is very important as the field of radiology is already suffering because of the increased cost of supplies and low reimbursements. To improve the collections, it is important to make the practices transparent and eradicate any kind of causes which are keeping the patients away from the radiologists.

The coding, compilation, and documentation of medical billing for radiology if done right will keep the revenue cycle moving and the radiologists will be able to put all of their focus on the diagnostics and treatments of their patients.