Radiology
Revenue Yield
Stop losing revenue on complex coding audits and modifier adjustments. Partner with Apex experts trained specifically in radiology guidelines.
Common Billing Challenges in Radiology
Practicing medicine requires your full focus. Unfortunately, navigating payer-specific guidelines, bundling edits, and coding specificity often causes clinical revenue to get delayed or written off.
Splitting professional component (-26) and technical component (-TC) claims for joint imaging agreements.
Tracking payer-specific clinical decision support mechanisms (CDSM) for high-tech imaging.
High rates of technical denials due to lack of documented medical necessity for CT, MRI, and PET scans.
Compliant Modifiers
Radiology claims require precise documentation and correct modifiers to justify reimbursement under strict NCCI guidelines.
Professional component, representing the radiologist's review and written report.
Technical component, representing the equipment, technologist, and imaging facility.
Distinct procedural service used to separate distinct scans performed on the same day.
Why General Billing Fails
- •Failure to report CDSM consulting G-codes and qualifiers
- •Overlooking MIPS and quality reporting measures on diagnostic claims
- •Split-billing errors between imaging centers and reading radiologist groups
- •Incorrect billing of contrast materials (Q-codes) alongside imaging codes
Interactive Claim Pipeline
Click on each workflow phase to inspect our protocols, software rules, and certified check systems.
CDSM & Auth Validation
Verifying CDSM consultation logs and pre-authorizations.
We verify that all advanced imaging orders contain the necessary CDSM consulting data (e.g., G-codes) and active auth codes.
Phase Protocols
Frequently Asked Questions
Ready to Optimize Your Radiology Yield?
Let us conduct a complimentary review of your billing records and codes to identify hidden leaks and contract underpayments.