The Current Procedural Terminology (CPT) coding is constantly under review and revision by the American Medical Association (AMA), The Centers for Medicare and Medicaid Services (CMS) and various other specialty medical societies. The goal is to not only keep the CPT coding up to date with new technologies and treatment procedures but also to make radiology billing, and the billing for all other medical procedures, more efficient and accurate.
In 2014 the biggest change in radiology billing coding is the bundling of multiple services from different medical specialties into a single code. Although this may be more efficient, it does not allow the medical establishment as much flexibility and in the case of many radiological procedures, results in a significant drop in reimbursement rate for certain procedures.
List of Newly Bundled Services
- Breast biopsies and insertion of devices - these codes are now bundled so that the actual procedure is combined with the imaging service used to complete the procedure. In some cases as many as five services and procedures are bundled into a single code. The result is a decrease in as much as 38% in reimbursement.
- Embolization - both transcatheter and non-head embolization procedure codes have been combined with the codes for the imaging services required to complete these procedures. These new bundles result in a decrease in reimbursement of up to 47%.
- Stent placement - in 2013 there were five codes used to bill for these procedures, now there are only two and the imaging services have once again been combined with the procedural services into a single code. This is predicted to result in a decrease in reimbursement of up to 20%.
- Abscess drainage - originally, these procedures were billed by codes based on their location in the body. Now all are billed using four bundled codes that include the necessary imaging services. This may result in a decrease in reimbursement of up to 10%.
Changes in Value of Existing Codes
Not all of the changes to the radiology CPT codes involve bundling of services. Some of the existing codes remain the same but the Relative Value Units (RVU) have been changed. This was done, in part, because of changes by CMS in the estimated amount of room time certain imaging procedures take.
These coding changes may also result in a significant reduction in the amount of reimbursement, particularly for some high value, frequently performed imaging procedures. These include, but are not limited to;
- MRI of the brain - the changes result in a 34% decrease in global billing rates.
- MRI of the spine - the changes to coding result in a 31% decrease in global billing rates.
- CT of the brain or head - the coding changes result in an 18% reduction in global billing rates.
- Ultrasound guidance - changes here resulted in a drastic reduction of 65% in global rates for radiology billing.
If all of this seems to be a bit too much to take in, relax. All you need to do is find a trusted partner to help you find you way through the maze of radiology billing. One that can guarantee you the proper reimbursement values to make sure that your practice is getting all of the money it deserves for the procedures given, a partner like Healthcare Information Services.
HIS has been meeting the needs of healthcare practitioners for more than 20 years. They are so good at what they do that typical clients see over 11% increase in their cash flow. Don't waste time trying to figure out the new 2014 radiology coding updates, contact HIS today and let them take care of it for you.