Building a Robust Radiology Coding Practice

2020 pandemic has profoundly impacted different industries globally, including healthcare facilities as well as the professionals who worked day and night to assist patients to get well soon! Radiology, a crucial specialty of healthcare diagnostics, experienced significant variances within its operations. As the world emerges from the pandemic, the future of radiology coding work is in need for transformation.

How Radiology Coding Works?

Diagnostic radiography processes like, MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography, CT (Computerized Axial Tomography) scans, and Ultrasonography need to be medically recorded/documented with the right set and use of medical codes. Radiology medical codes (and for that matter, codes for almost every other specialty) are constantly being updated and it’s crucial for radiography and imaging facilities to stay aware of these changes. Each and every insurance service provider needs correct and accurately coded medical claims in order to provide the correct reimbursements.

Still radiology claims getting denied is alarmingly common, with payers regularly turning down medical claims due to faulty coding. For example, if a patient takes an MRI scan then it should be mentioned properly within the patient’s medical record which would help in getting the due reimbursement as stipulated under the patient’s health plan.

Therefore, it’s easy to see how getting radiology coding right is so very important for maintaining a healthy flow of revenue. It is as important as verifying whether the patient is eligible for the procedure or the insurance policy is active or expired.

Benefits of Radiology Coding

Radiology coding is very important for the healthcare system it plays an important role in assuring proper billing, reimbursement, and documentation for imaging services. Here are 4 aspects that may help to get a better understanding of why radiology coding is one of the most critical parts of the revenue cycle:

  • Accurate Reimbursement and Radiology Billing: Using the right codes for imaging services assures that healthcare diagnosis is appropriately translated into standardized radiology codes, enabling healthcare facilities to submit claims to the insurance service providers. Proper coding helps in minimizing claim denials, reimbursement delays, and maximizes revenue collection for healthcare facilities.
  • Better Reporting and Data Analysis: Radiology coding helps in generating useful data which can be analyzed for identifying patterns, trends and scope of improvement. Data analysis helps healthcare facilities to make legitimate decisions in regards to process improvement, strategic planning, and resource allocation. Be it ultrasound, imaging, radiology, X-ray or MRI, coding helps in identifying different opportunities for revenue improvement.
  • Correct Medical Documentation: Radiography coders work closely with radiology professionals and healthcare professionals (HCPs) to provide detailed and information oriented medical documentation. Thus, healthcare professionals can get quicker payments from insurance companies while the medical documentation can be used for future references.
  • Boost Patient Safety and Care: Accurate radiology coding allows healthcare professionals to communicate important medical information regarding the patient’s upcoming/ongoing treatment plans, medication and overall diagnoses.

It is evident that medical billing and coding for Radiology practices is an important activity not only in respect to proper documentation in the patient’s health records, but also in ensuring that imaging service providers get compensated for their services.