One of the hot topics of discussion for many organizations is whether to open a free-standing center to perform interventional procedures. And, to take it one step further, should the free-standing center be an outpatient-based lab (OBL) or an ambulatory surgery center (ASC)? The answer really does depend on the organization’s goals, resources and needs.
Browsing: Coding/Billing
To be clear, I am a strong advocate for interventional radiologists appropriately billing for evaluation and management (E/M) services. Technically the E/M visit codes are available for use by all specialties but everyone must be mindful that all criteria of the code family must be met, the medical record documentation must support the billed level and type of service and the medical necessity for the visit must be clear.
The beginning of the year always brings new coding changes as well as other changes, such as updates to the Centers for Medicare and Medicaid Services (CMS) National Correct Coding Initiative (NCCI) guidelines and coding edits.
Changing payer guidelines and pending regulations changes from Mammography Quality Standards Act (MQSA) has this topic back in the spotlight.
Evaluation and management (E/M) guidelines have changed significantly the past couple of years, and this is appropriately challenging many radiology practices to re-evaluate their coding and billing practices.Â
Positron emission tomography (PET) is a nuclear medicine study that creates cross-sectional tomographic (3D) images of the metabolic activity in the patient’s tissues. Cancers can cause abnormalities of blood flow or metabolism before structural changes are visible, and for this reason PET can often detect cancer at an earlier stage than CT or MRI.
Most of the waivers and provisions don’t impact radiology services but there are a few that should be reviewed, as they may impact your organization.
Artificial intelligence (AI) has been around for many years in radiology. From a clinical to an efficiency perspective, it has and continues to be a hot topic for discussion. It is natural then that the question of reimbursement should enter into the conversation.
If your radiologists perform reads in a different geographic location from where the patient received their service, you may have more credentialling requirements than you realize
Nonphysician practitioners may be able to perform and bill for services independent of a physician, depending on the Centers for Medicare and Medicaid Services (CMS) guidelines and state scope of practice statutes.
