Melody Mulaik is a featured writer for ICE magazine’s billing and coding column. Melody is the president of Revenue Cycle Coding Strategies in Powder Springs, Georgia. The corporate office is located in Cedar Park, Texas. She has a masters of science in health systems and a bachelor’s degree in industrial engineering from the Georgia Institute of Technology. Melody’s certifications include CRA, RCC, RCC-IR, CPC and COC. In addition to managing a consulting and publishing firm with clients in all 50 states, Melody is an active presenter and writer in the specialty area of radiology coding, billing and compliance. When she is not working, she is an extensive traveler, travelling to all 50 states, as well as quite a few countries.
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If your radiologists perform reads in a different geographic location from where the patient received their service, you may have more credentialling requirements than you realize
Nonphysician practitioners may be able to perform and bill for services independent of a physician, depending on the Centers for Medicare and Medicaid Services (CMS) guidelines and state scope of practice statutes.
Just because there is a procedure code for a service does not mean that it is accepted and/or reimbursed for all payers.
CMS believes that the earliest that its claims processing system can begin screening claims using the AUC program claims processing edits for the payment penalty phase is October 2022.
In some practices there are situations that arise where the radiologists are asked to interpret images, aka “spot” images, in conjunction with other procedures, typically performed by other specialties.