Coding precision is vital for radiology practices to get paid for rendered services. Since coding inconsistencies are quite common in radiology environments, it becomes necessary to have expert billers and coders working for the practice.
The main reason behind coding inconsistencies is that the professional and technical billing processes don’t often overlap. There are chances a technologist focused on patient care will miss the charge-capture updates that are required for reflecting a change in patient procedures or supplies being used. Even a busy radiologist may interpret an exam using a different procedure name or may not have the necessary documentation for supporting coding for a certain procedure even though it was completed. Due to this disconnect, a greater risk of compliance issue crops up and it leads to under-coded or lost charges.
Every radiology practice is dependent on the proper execution of a complex chain of diagnosis and disease coding and procedural coding. But unfortunately, not all radiologists are aware of the important link between the two coding systems.
Inconsistencies in coding noticed by payers can leads to denials, delayed payments and an increased risk of compliance. With ICD-10, coding challenges have increased. This has pushed the need for trained coders who have a good understanding of the codes. Also, radiologists need an expert team of billers who understand the complexities of the reimbursement system and who can help the providers comply with the changing directives.
Errors in coding cost an average radiology practice the equivalent of a full time coding professional. Errors also leave the practice vulnerable to compliance risks. So it is very important for practices to provide adequate documentation to the coders so that they have the necessary data for maximizing revenue. The coders need to be well-trained and experienced because if they are over-coding, then it will threaten compliance and if they are under-coding, it will result in lost revenue.
In order to deal with radiology coding challenges, many providers have started outsourcing their reimbursement needs to a third party. They are hiring a billing partner to get access to their team of certified coders who are specialized in radiology coding. Billing companies not only help radiologists overcome revenue challenges but they also help the providers identify deficiencies in their documentation. This is necessary for improving the quality of medical records and also for optimizing reimbursement.