You can also adhere to medical regulations. These practices prevent reimbursement delays from insurers. Read on to learn more about radiology billing and its benefits.
Overview of Radiology Billing Services
Radiology billing services generate medical bills and receive payments. These bills and payments are for radiological procedures. The procedures are based on diagnostic imaging. They include X-rays, MRIs, CT scans, and ultrasounds.
There are two components of medical billing for radiology. Healthcare providers call them professional and technical. The professional component is based on the expertise of radiologists. It includes the practices conducted under your supervision.
The practices include imaging, interpreting images, and writing test reports. In comparison, the technical component is based on your radiology equipment and supplies. You use these resources during the radiology exams of patients.
It can be stressful and time-consuming for you to manage radiology medical billing. You should assign accurate codes to your procedures in radiology reports. Only accurate codes ensure that you receive timely reimbursements.
Such reports include patient details like their names and referring physicians. They also contain the date and time of radiological procedures. Medical billing for radiology can get demanding as well due to its numerous exams.
How Does Radiology Billing Help?
1. Coding Precision
Radiology procedures comprise a lot of diagnostic and imaging tests. Each test has a different code for its medical bill. You can provide these billing services to assign precise codes. Precise codes ensure that you follow the CPT and ICD coding standards.
Precise codes are essential for hospitals. You can use them to claim full reimbursements from insurance providers. This practice reduces the risk of underbilling and claim denials.
2. Timely Claim Submissions
Medical billing for radiology services can also be efficient. For that, you have to timely submit your claims. Delays in claim submissions can prolong revenue cycles. They can even disrupt your cash flow.
You can provide billing services to ensure that you submit claims on time. Your reimbursement process can become better. Healthcare providers are able to maintain a steady revenue stream.
3. Regulatory Compliance
There are a lot of regulations placed for medical billing. Various government agencies place them. Some private insurance entities also regulate hospital bills.
These regulations are frequently updated. You can easily provide billing services for radiology based on those updates. This way, hospitals remain compliant with them.
Regulatory compliance protects you from legal issues. It also helps hospitals increase their reimbursements. They do not have to face any non-compliance penalties.
4. Prevents Billing Errors
Billing errors can cause claim denials and revenue loss. These errors can occur while assigning codes and recording patient documents.
You can implement quality checks in radiology billing. These checks can identify and rectify errors before you submit claims.
This way, you can avoid unnecessary delays. Hospitals can ensure a high number of approved claims. They can also receive quicker reimbursement.
5. Plans Revenue Optimization
A billing service for radiology is more than a basic billing practice. They provide strategies on how to increase medical revenue. You can use those strategies to analyze payer trends.
You can also negotiate your contracts with insurance providers. These steps can improve your billing performance. They can also increase your revenue streams.
Benefits Of Outsourcing Radiology Billing Services
Outsourcing a medical billing service for radiology can be beneficial for hospitals. There are cost benefits associated with it. Other benefits include speed, accuracy, security and many more. Let’s take a look at those benefits in detail:
1. Faster Diagnosis
Now, you do not have to wait long hours. Your radiology images can be interpreted in no time. Outsourcing companies like Health Quest Billing can take care of that. They can also start your diagnosis process.
Doctors also do not have to worry about any downtime. The companies can interpret your images as soon as the radiology images are transmitted.
This means that interpretation starts, and the final reports are sent to the doctor in no time. This way, you can speed up the delivery of patient care by several notches.
2. Data Safety
The information documented in medical files is valuable for hospitals. Outsourcing your billing services can enhance your data safety.
Outsourcing companies have expert billing teams. They are always ready to allocate necessary resources.
These resources can protect your patient information. You can also ensure that the chance of a data breach is minimal.
3. Cost Benefits
Outsourcing radiology billing services also brings cost benefits for hospitals. You do not have to invest a large amount of capital. Outsourcing companies are generally affordable and provide optimum billing services.
You can avoid expensive software and employee training. Your administrative costs are also reduced. You can also focus on your main billing processes.
4. Timely Payments
Payments are important for any hospital. They are also vital for you to expand your radiology services. The skilled professionals in outsourcing companies can improve payment posting.
They can also ensure that you timely receive them. This way, you can reduce revenue loss due to claim denials. You can submit your claims more quickly and receive faster payments.
5. Improves Revenue Cycle Management
You can outsource radiology billing services to improve your revenue cycle management. Outsourcing companies have experienced professionals.
They are well-versed in medical coding and billing. You can hand over the coding process to them. They can assign accurate codes to your radiology services.
You also do not have to worry about following up on claim denials. These practices will help you get paid faster and improve your cash flow.
Common Radiology Billing Mistakes to Avoid
1. Inaccurate Documentation in Radiology Tests
Take an example of a knee exam. Hospitals have to assign four different CPT codes to it. Assigning the accurate one is based on the number and type of views.
You may have to code to the lowest level in case of inaccurate documentation. You may have to do more than a list of standard views for each exam.
The imaging report should also specify the radiology practice. This way, your coders can choose the accurate codes.
For knee exams, “four views of the knee” is acceptable for medical reports. An even better practice for radiologists is to give details. Examples like AP, lateral, and obliques can support the relevant code.
2. Missing Out Key Details
The American College of Radiology has set a strict policy for imaging reports. They have to include several details to be completed.
They include the exam name, reason, and description of the exam. The techniques are also mentioned apart from comparison studies if applicable.
In addition, findings, conclusions, and recommendations are included. The reports contain a physician’s signature at the end.
Other key components include laterality where applicable. There are details if a study is a repeat of a prior study. You can skip some of these elements, and your reimbursement can get delayed.
3. Inability to Document Scout Films
A scout film is performed with an upper GI series. You can support the correct code by dictating the KUB and findings separately.
You cannot meet documentation requirements just by obtaining preliminary films. An esophagram is bundled into the upper GI series.
However, you may have to perform several views or a cine esophagram. Documentation may support the medical necessity for a separate esophagram. You can code it separately with a modifier -59.
4. Incomplete Documentation of Ultrasound Exams
Hospitals have strict criteria for complete abdominal ultrasounds and renal ultrasounds. They determine these services by documenting each organ or structure in medical reports.
This way, you can justify the complete codes. In case of a missing anatomical structure, you must down-code to a limited study. There has to be a permanent record and measurements for diagnostic ultrasound studies.
5. Invalid Contrast Studies
Another common mistake is incompletely or incorrectly documenting and coding services. CT scans and MRIs are only considered contrast studies in case of intravenously administered contrast.
You cannot count oral and rectal contrast as a contrast study. Your documentation should accurately show how the study was performed. Radiologists can perform it with or without IV contrast.
They also look for coding parentheticals. This way, they can identify additional coding opportunities in contrast studies. The type and amount of contrast for HCPCS coding should also be documented.
6. Inaccurate Documentation
Radiopharmaceuticals are not included in diagnostic nuclear medicine and PET scans. You have to bill them separately.
You must clearly document the type and amount of radiopharmaceuticals. These records are maintained in the technique portion of the study. This is done before adding the supply codes.
How to Prevent Radiology Claim Denials?
1. Documenting Patient History and Referring Physicians
You must thoroughly document the medical history of your patients. A good history provides the signs and symptoms being presented.
Your referring physician can also provide reasons for the referral. The reasons can include those symptoms.
Some referring physicians are better at providing complete histories. Such histories contain all the signs and symptoms.
2. Denial Analysis
You must review the insurance denials of your patients. They can reveal patterns about referring offices. This way, you can determine which offices are responsible for more denials than average.
You can use those details to work with the scheduling staff. They can get more complete information from those particular offices.
3. Work with Technologists
You can also work with technologists to prevent radiology claim denials. They can collect key details at the time of the radiology exam.
Hospitals must ensure that modality worksheets are reviewed. They should include questions about the history, signs and symptoms of patients. You can also ask about their previous imaging.
4. Documenting Radiology Procedures
Radiologists should have as much information about the patient as possible. They should include the relevant details in documenting their procedures.
This enables coders and billers to properly prepare their claims. It may also be helpful if the payer either audits the case or requests additional information.
5. Improve Billing Process
Healthcare providers must ensure their claims submission is clean for radiology billing services. They have to constantly improve their billing process.
This way, they can put an end to all the reasons for claim denials. It is vital that you have an experienced team to manage your billing practices.
6. Internal Claims Audit
You should also have a regular internal claims audit. Regular audits include a comprehensive analysis of your billing risks.
This way, you can conduct claim denial management. Furthermore, audits also enable you to set up all mandatory requirements.
They can include staffing to upgrade tools for radiology billing services. This will increase your cash flow and result in targeted success.
What Are the New Radiology Billing CPT Codes?
1. Diagnostic Radiology Procedures
These procedures include different imaging techniques. They include X-rays, CT scans, and MRIs. These techniques are important for in-depth diagnosis and evaluation.
The 70010-70559 codes are assigned to X-rays and imaging for head and neck conditions. You can assign the 71045-71555 codes to these techniques for chest issues.
Whereas the 72020-72295 codes are for X-rays and myelography. These techniques assess musculoskeletal cases.
Upper limb conditions are diagnosed using the 73000-73225 codes. Furthermore, the 73501-73725 codes are assigned to the X-rays that assess lower limbs.
2. Diagnostic Ultrasound Procedures
These procedures involve non-invasive imaging. They use high-frequency sound waves. These waves visualize various body parts. You can use these visualizations to assess the relevant medical conditions.
Diagnostic ultrasound procedures are categorized into specific areas based on their detailed evaluations. The 76506-76536 codes are assigned to ultrasounds.
These ultrasounds are conducted to assess head and neck conditions. You can assign the 76604-76642 codes to conduct ultrasound scans for chest conditions.
Any abdominal and retroperitoneal cases are evaluated using the 76700-76776 codes. In comparison, the 76800-76800 codes are specifically assigned to spinal canal conditions.
3. Radiation Oncology Treatment
These services include cancer radiation therapy procedures. The 77261-77299 codes are assigned to treatment planning for radiation therapy.
They include both external and internal sources. The therapy equipment and dosimetry services are linked with the 77295-77370 codes.
In addition, you can assign 77371-77387 codes for stereotactic radiation delivery. Moreover, neutron beam therapy procedures are assigned the 77423-77425 codes.
The Bottom Line
To sum up, mastering efficiency in radiology billing is crucial for financial health and regulatory compliance. Outsourcing services offer benefits like faster diagnosis, data safety, cost savings, and improved revenue cycle management. Avoiding common billing mistakes and implementing preventive measures ensures a streamlined process.
Contact Health Quest Billing for such expert solutions and unlock the full potential of your radiology practice.