In practice
Coding, billing and reimbursement
One of SIR’s key member benefits is the work that staff and volunteers undertake in both suggesting new CPT codes and helping to value approved codes.
Reimbursement dictates more than the average IR’s paycheck: reimbursement rates determine access to care, available procedures and patient expense. It’s part of the tricky economics of healthcare, and there is nothing as crucial to reimbursement as the management of CPT codes.
One of SIR’s key member benefits is the work that staff and volunteers undertake in both suggesting new CPT codes and helping to value approved codes. It’s an arduous process, but one that relies on the volunteer work of committed SIR members. Over the last 14 years, SIR has led 289 codes through this process to allow reimbursement for procedures performed by interventional radiologists.
Our structure
Carrier advocacy workgroup
This group prevents the enactment of interventional radiology coverage policies and works to modify coverage policies that adversely affect SIR members. Our team develops evidence-based letters to help overturn carrier policy, denied authorizations, denied claims and comment letters to purposed payor policies.
Coding application and guidance workgroup
This workgroup is devoted to eliminating barriers in IR billing by providing coding guidance to SIR members. Our team constructs IR educational content to stimulate the demand for high-quality billing by increasing the value of SIR member resources.
SIR CPT® Editorial Panel and RUC workgroup
This workgroup oversees and executes interventional radiology CPT® and RUC development. Our team works with the AMA and CMS to ensure that IR CPT® codes reflect the latest medical care available to patients while safeguarding the work of IR physicians by ensuring physician work is properly reflected through the RUC process.
Economics commitee
The SIR economics committee is dedicated to demonstrating interventional radiologists’ value to the healthcare systems. Our team interfaces with payers on proposals to update payment rates, policies, and regulations preventing patient access to care.
Are you really an interventional radiologist?
Check your taxonomy code
Is your practice using the correct specialty code to capture your work as an interventional radiologist? The Healthcare Provider Taxonomy Code identifies specialties for service providers in insurance claims.
Appropriate use of specialty codes reduces inappropriate suspensions, improves the quality of the utilization data, and allows billing for evaluation and management codes in the case of IR. SIR urges all IRs to verify with their insurance carriers that they are registered as code 94—interventional radiology.
Your coding questions answered
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Your coding questions answered
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Your coding questions answered
Health Policy Affairs
On the fourth Wednesday of each month, Health Policy Affairs delivers the latest advocacy and economics news from SIR's health policy and economics division.
Latest education
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Latest education
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Latest education
Coding and E/M toolkits
These toolkits curate an array of society and external resources designed to help you better understand and meet the AMA CPT® codebook rules and guidelines.