Coding changes will have significant impact on radiology in 2014

Coding system changes will result in reimbursement shifts and--with the implementation of ICD-10--significant changes in the way charges are captured and services coded in 2014, according to an article in Diagnostic Imaging.

"To me, 2014 is all about ICD-10," Melody Mulaik (pictured), president of CSI Coding Strategies, told Diagnostic Imaging. "It will dwarf everything else."

The implementation of the new system goes into effect Oct. 1, 2014. While the current ICD-9 system has 14,000 codes, ICD-10 has more than 69,000 codes, which will require providers and referring physicians to be much more specific with diagnoses and documentation.

During the American Healthcare Radiology Administrators fall conference in Baltimore in October, Mulaik said that while radiologists will avoid much of the pain associated with the conversion to ICD-10, they will have other concerns. For instance, she said, one area where radiologists will need to be especially alert will be clinical data reporting.

"Think about the quality of the clinical data you receive [from referring physicians]," Mulaik said. "How many of you always have referring physicians give you all the details you need? That's going to get worse in ICD-10."

Because radiologists are so reliant on the hospital or other systems for information, Mulaik told Diagnostic Imaging, problems easily could arise if a radiologist doesn't receive enough documentation from a referring doctor.

There are other coding changes coming in 2014 that will impact reimbursement levels, as well. For example the Medicare Physician Fee Schedule (MPFS) final rule contain six new codes that bundle breast biopsy with the imaging guidance used--either stereotactic, ultrasound, or MRI--each with an add-on code to describe additional lesions. According to the American College of Radiology, these new codes will result in reimbursement cuts ranging from 29 to 54 percent.

On the other hand, there are eight new codes that bundle marker placement with imaging guidance used--either stereotactic, ultrasound, mammographic or MRI--that will actually result in a 17 percent increase in reimbursements.

To learn more:
- read the article in Diagnostic Imaging
- see this report from ACR about new codes in the MPFS

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