Why Radiology billing is different.
Radiology billing expertise.
- Modifier -26 and -TC billing for split services
- Contrast versus non-contrast study coding
- Interventional radiology procedure coding
- Screening versus diagnostic mammography billing
- Multiple procedure payment reduction handling
- Authorization tracking for advanced imaging
- Appropriate use criteria reporting where required
- Teleradiology and multi-site billing
Common Radiology codes we work with.
| Code | Description |
|---|---|
71046 | Radiologic examination, chest, 2 views |
70553 | MRI brain without contrast, followed by contrast and further sequences |
74177 | CT abdomen and pelvis with contrast |
77067 | Screening mammography, bilateral, including computer-aided detection when performed |
76700 | Ultrasound, abdominal, real time with image documentation, complete |
72148 | MRI spinal canal and contents, lumbar, without contrast |
CPT® is a registered trademark of the American Medical Association. Codes shown are examples; correct coding depends on documentation and payer policy.
Our processRadiology billing process.
Order Intake and Authorization
- Eligibility checks for every scheduled study
- Prior authorization requests for advanced imaging
- Matching the ordered study to the authorized CPT code
- Flagging expired or mismatched authorizations
Radiology Coding
- Coding from the final signed report
- Contrast, view count and laterality accuracy
- Component modifiers for professional and technical billing
- Interventional and image-guided procedure coding
Claim Submission
- Scrubbing for NCCI and multiple-procedure edits
- Correct diagnosis linking from the report impression
- Separate professional and facility claim workflows
- High-volume batch submission with daily reconciliation
Denial Management
- Authorization and medical necessity appeals
- Component and modifier corrections
- Underpayment identification against fee schedules
- Root-cause fixes at the scheduling desk
Reporting and Analytics
- Revenue by modality and site
- Reads per radiologist and turnaround tracking
- Payer mix and reimbursement trends
- Denial patterns by study type
Radiology billing FAQs.
When should modifiers -26 and -TC be used?
Modifier -26 reports the professional interpretation and -TC reports the equipment, staff and facility portion. If your practice owns the equipment and reads the study, you bill the global service with no modifier.
What happens if the study performed differs from the one authorized?
Many payers deny the claim if the CPT code doesn't match the authorization, such as a with-contrast study authorized as without contrast. We catch these mismatches before submission and work with your team to update the authorization when possible.
How do you bill screening versus diagnostic mammograms?
Screening mammograms are for patients without symptoms and are coded differently from diagnostic studies ordered for a finding or complaint. When a screening converts to diagnostic on the same day, we apply the correct codes and modifiers so both services are paid.
Can you handle billing for multiple imaging centers?
Yes. We set up site-specific workflows, provider enrollments and reporting so each location's performance is visible on its own and in total.