Radiology Reporting (Part 1, Technical Review of Outpatient Radiology Services)
In this session, we’re going to get technical about outpatient radiology services. Some review organizations have gotten technical too and have made this topic part of their focus. We won’t be discussing specific codes for reporting; but rather, we will be digging deeper into the technical billing requirements and issues that affect reporting of radiology services.
Attendees will be able to:
- Utilize learned information to make logical decisions regarding modifier use for radiology services.
- Describe how and why radiology services are a focus of reviewers.
- Apply rules for selecting the diagnosis and achieve medical necessity for reported services.
- Describe key denial issues with radiology claims and apply the knowledge to assess internal processes.
Course Objectives:
- Review the importance of modifiers for accuracy and payment;
- Discuss how these services are billed under Medicare and the data elements needed for the claim form;
- Discuss medical necessity; and,
- Examine the top denial reasons and review focus areas for external reviewers such as the RAC’s.
This course authored by Heather Bryans and Paula Digby.
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