Feature
E/M coding
Optimizing and capturing the full scope of IR
nterventional radiology has evolved into a complex, wide-ranging specialty that can touch all corners of the hospital system—but that
evolution has outpaced many healthcare documentation systems.
While some systems treat IR as a clinical specialty with consult-based workflows, others still classify it as radiologists working under an order-based system. This creates inconsistencies in how procedures are managed and billed, often resulting in additional administrative work for IRs and missed opportunities for reimbursement.
“Epic really keeps IR to its roots of radiology, and treats us like one of the radiology subspecialties,” said Sebouh A. Gueyikian, MD. Dr. Gueyikian, a member of the Association of Chiefs in
Interventional Radiology, spoke on the challenges of capturing evaluation and management (E/M) revenue at the fall ACIR meeting.
According to Dr. Gueyikian, most IR services are utilizing systems optimized for radiology, where every single action is considered a billable encounter. However, that is not the case for IR— especially when it comes to evaluation and management coding.
Capturing your work “IR historically has not been very good at E/M coding,” Dr. Gueyikian said, largely because it traditionally has not been included in training, meaning most IRs have had to learn it on the job. “E/M coding is like a conversation and a language that all other doctors who
don’t do procedures speak, and we are just starting to learn it.”
Most facilities use Epic, which is meant to be the global place where all physicians interact, and which automatically captures the billing for those interactions. But a lot of evaluation and management work happens outside of Epic, and Dr. Gueyikian wants IRs to know they can capture that, as well.
Because IR is at the intersection of radiology, minimally invasive procedures, and the clinical realm, IRs receive a huge number of requests for second opinions, recommendations or report interpretations. Because that work wasn’t captured in Epic, a physician could be asked about the same patient multiple times from different services.
Additionally, many referrals do not actually result in procedures—but it takes time for IRs to determine that.
“We can spend 10-15 minutes looking through a chart before realizing the patient isn’t a good candidate for IR therapy. That’s 10-15 minutes of your time lost, and there are some IRs who simply
irq.sirweb.org | 19
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40
