As you no doubt know, medical billers and coders can specialize, focusing on certain fields within the medical industry. One of those very common fields in which people choose to specialize is radiology, or diagnostic imaging. But how do you improve your skills, especially if you are new to this segment of the healthcare industry? Here are 5 tips…
1. Monitor medical necessity and ask for advanced beneficiary notices (ABNs) on Medicare patients. When a service is not covered by Medicare due to lack of medical necessity an ABN should be provided to the patient. The ABN can cover the facility technical component and the professional component fee. The professional component ABN is frequently missed due to the assistance needed from the facility staff as well as the transmittal of the ABN (which is often in hardcopy) back to the billing company.
A radiologist should work with the facility staff at the patient’s hospital to ensure the ABN also lists the professional component fee. Additionally, the radiologist should request their billing company monitor trends from ordering physicians. These physicians need to be aware of the Medicare covered conditions prior to writing an order for a specific service. Radiologists should also coordinate with the billing company so they can receive a copy of the signed ABN from the patient. This coordination may seem clunky at first, but once a process is put in place, radiologists will experience fewer patient write-offs.
2. Keep up to date on required dictation needs. With audits such as Recovery Audit Contractors (RACs) and Comprehensive Error Rate Testing (CERTs) becoming a part of standard processes, radiologists need to be aware of the verbiage needed to describe the exams performed. Knowing the correct verbiage will help to eliminate costly appeals or having to provide additional information long after the original date of service. For instance, if a physician is dictating a CTA, they should be including documentation of 3D imaging.
If a radiologist is not receiving communication on CPT updates or feedback on documentation and where opportunities exist from their billing company, they should definitely ask. Resources to aid in identifying documentation requirements include the current version of AMA CPT, CPT Assistant and Clinical Examples in Radiology….
In addition to improving your efficiency, it's important to stay abreast of all current updates; there have been changes made to the radiology coding procedures which you need to be aware of…
Hopefully this has made it easier for you to submit diagnostic imaging billing information more quickly and accurately!