Radiology Medical Billing Services - Compare Quotes From Vetted Providers

Component billing is the default

• Most imaging allows split billing. Use modifier 26 for the professional interpretation and modifier TC for the technical component when different entities bill. Submit the global code only when you own both components and payer rules allow it.
• Place of service and ownership determine who may bill each component. Confirm where the scan was performed and who owns the equipment.

Orders and medical necessity

• Every study must have a valid order that matches modality, body part, laterality, and contrast status.
• Link ICD-10 diagnoses to the clinical indication on the order and report. For common screening or surveillance scenarios, use the correct screening codes.

Contrast, phases, and sequences

• CT and MRI coding changes based on contrast use. Document without contrast, with contrast, or both without and with contrast, and ensure the claim mirrors the final report.
• Multi-phase liver or renal protocols may have specific code families. Align documentation with the protocol performed.

Guidance and interventional radiology

• Many image-guided procedures include guidance in the primary code. When separate guidance is allowed, ensure the note includes modality, target, approach, and confirmation of needle or catheter position.
• For interventional radiology, capture all billable components: access, catheter placements by vascular family, diagnostic imaging when not bundled, therapeutic service, closure, and moderate sedation when not inherently included.

Supervision levels and incident-to in imaging centers

• Technical services require the appropriate level of physician supervision per modality. Ensure supervision levels are met and documented in policies and schedules.

Views, limited vs complete, and image counts

• Plain film radiography requires the number of views to support code selection.
• Ultrasound must document limited vs complete criteria by anatomic area and include required elements. Vascular duplex studies need both B-mode imaging and Doppler to meet the code definition.

3D post-processing and advanced reconstructions

• Bill 3D rendering only when performed and documented with independent workstation post-processing. The report should describe datasets, reformats, and clinical utility.

Laterality and modifier usage

• Use RT, LT, or appropriate site modifiers when required by payer policy.
• Consider 59 or X modifiers when distinct non-overlapping studies of different anatomic regions are performed and edits bundle services.
• Append 52 for reduced services when a complete study was intended but not fully performed, and 53 for discontinued procedures when applicable.

Prior authorization and site-of-care rules

• Advanced imaging often requires prior authorization. Capture auth numbers at scheduling and transmit with the claim.
• Some payers steer MRI and CT to freestanding sites. Verify site-of-care rules before scheduling to avoid denials.

Critical results and turn-around documentation

• Document communication of time-sensitive or critical findings to the treating provider. Many quality programs require this and auditors review it.

Keeping billing in-house can work well when you have a stable team, predictable volume, and the capacity to hire, train, and cover vacations or turnover. You retain tight control over workflows but you also carry the risk and cost of staffing, QA, software, and performance management.

Outsourcing shifts those burdens to a specialized team that brings SLAs, denial management, and scalable capacity. It’s often a fit when claim volume is growing, denials are creeping up, or leadership wants to redeploy staff to patient-facing work without sacrificing cash flow.