Whitney Palmer

How to Increase Reimbursements

Published on the March 15, 2018 DiagnosticImaging.com website

By Whitney J. Palmer

For the second year running, the coding and reimbursement world is relatively calm for diagnostic imaging. Instead of seeing massive payment cuts or a slew of changes to codes this year, you’re simply going to have to wait longer for your money.

But, even that lag time can cause problems, industry experts say.

Over the next several months, there are a few things you should watch for—they could add dollars to your bottom line.

National Correct Coding Initiative Edits

If you do many chest X-rays with abdominal studies, chances are you’ve noticed your claims have been denied all year. According to Maria Tran, assistant director of coding for the American College of Radiology (ACR), the reason is simple. The Centers for Medicare & Medicaid Services (CMS) included unannounced edits in the 2018 final rule.

It’s an oversight that took the industry by surprise, and its schedule will be corrected by April 1 as part of the National Correct Coding Initiative edits. Still, until that date, getting reimbursement for those claims will be difficult.

You do have options, however, to facilitate payment:

1. You can hold on to any chest X-ray with abdominal studies claims from January 1 to March 31 of this year and submit them after April 1.

2. You can continue to have your staff submit the claims, receive the denial, and correct the claim for re-submission.

3. You can code for the procedure differently. Instead of using 71045, single view chest X-ray, to code for the procedure, submit 74018, one view abdominal X-ray, with a -59 CPT modifier. Pursuing reimbursement this way will ensure you’ll receive payment for both services provided between January 1 and March 31.

If you work for a practice that operates in several states, though, be sure everyone is consistent, says Karna Morrow, diagnostic coding trainer for CSI Coding Strategies. Otherwise, some of you will get paid, and others won’t.

Most importantly, she says, choose a claim submission strategy that works best for you. Assess your financial situation and what might be most beneficial for your practice.

“Evaluate your operational needs and make a decision,” she said. “That way, you can make a conscious decision instead of just pushing everything out the door and getting denials.”

To read the remainder of the article published at its original location: http://www.diagnosticimaging.com/reimbursement/how-increase-reimbursements

May 17, 2018 - Posted by wjpalmer | Uncategorized