Radiology billing services is very technical, particularly in distinguishing the ordering physician from the rendering physician. Misunderstanding these roles can generate errors in billing, compliance, and delayed payment.
In this new updated 2025 guide, Med Billing RES distinguishes differences in these two most essential roles, emphasizes new CPT code updates, and offers best practices to make radiology billing 2025 easy and get paid faster.
Understanding Roles: Ordering vs. Rendering Physician
Ordering Physician
- Orders Imaging Services: The ordering physician (most often a specialist or primary care physician) determines the diagnostic imaging, e.g., MRIs, CT scans, or X-rays, and orders it.
- Does Not Render Procedures: Their role is restricted to determining clinical necessity and referring the patient to imaging centers or radiologists.
Rendering Physician
- Performs and Supervises the Service: The rendering physician, perhaps a radiologist, performs or supervises the imaging and ascertains proper performance.
- Provides Interpretation: They interpret images and produce a thorough diagnostic report in support of treatment planning.
Key Takeaway Of Radiology Billing Services
Inaccurate reporting of these duties lies at the core of compliant billing and clean claim submission.
Technical vs. Professional Elements in Radiology Billing
Radiology billing tends to distinguish between technical (TC) and professional (PC) services.
Component Of Radiology Billing Services
What It Covers
- Technical (TC): Imaging equipment, staff, and facility use
- Professional (PC): Radiologist report, interpretation, and review
Billed By
- Technical (TC): Hospital or facility imaging
- Professional (PC): Rendering physician or radiology practice
Modifiers to Remember:
- TC: Technical component alone
- 26: Professional component alone
Using these modifiers correctly prevents claim denials and properly compensates the two parties.
New CPT Code Changes in Radiology billing Services
The American College of Radiology Billing (ACR) has added new Category I CPT codes and retired old ones. Here are the key points:
MR Safety Procedures
- 7XX00-7XX05: MR safety tests, implant preparation, and customization with written reports
MRI-Monitored TULSA
- 5X006-5X008: MRI-guided prostate tissue ablation procedures
MRgFUS
- 0398T: Redesignated Category I; includes planning, insertion, and ablation
Transcranial Doppler Studies
- 93893: Updated emboli detection code with modified reporting requirements
Fascial Plane Blocks
- 64486-64489: Renumbered TAP block codes for bilateral and unilateral injections and infusions
Thyroid Ablation
- New Code: Added per CPT added for percutaneous RF ablation with add-ons for other nodules
CT Colonography
- Officially included in Medicare coverage for colorectal cancer screening
Common Radiology Billing Services Pitfalls
1. Inappropriate Coding: Undercoding & Upcoding
Both scenarios impact compliance and reimbursement:
- Undercoding: Reimbursement for a less complex procedure than actually done (results in underpayment).
- Upcoding: Charging for a more complex procedure than was actually done (will result in audit or penalties).
Solution: Ongoing coding audits, employee education, and computerized claim scrubbing.
2. Insufficient Documentation
Insufficient, or lacking, medical necessity documentation by the ordering physician is most commonly the cause of denials. Reporting radiology must be conformant with CPT codes billed.
Solution: Utilize standard reporting forms and add EMR prompts for necessary information.
3. Payer-Specific Rules Of Radiology Billing Services
Government and commercial payers repeatedly revise authorization, bundling, and reimbursement policy.
Solution: Appoint a payer liaison to track policy changes and revise internal procedures.
Practices for Accuracy in Radiology Billing Services
- ✅ Keep It Simple: Keep ordering and rendering physicians in sync to avoid claims denials.
- ✅ Quarterly Audits: Catch coding discrepancies before they become costly issues and train personnel accordingly.
- ✅ Monitor Regs Regularly: Review ACR, CMS, and payer guidelines periodically.
- ✅ RCM Software Utilization: Automatically scrub claims, cross-check codes, and track denials.
- ✅ Expert Assistance: Med Billing RES provides radiology-specialty billing, reducing A/R days by 30%.
Why Med Billing RES for Radiology Billing Services?
- Specialty-Specific Staff: AAPC-certified radiology billers and coding specialists
- AI-Driven Automation: Accelerated claim submission with real-time error identification
- 98%+ Clean Claim Rate: Proof of denials minimized
- Compliance-First Culture: Stay ahead of the curve on coding news and audits
2025 radiology billing methods can prioritize patient care with Med Billing RES, since we take care of billing accuracy, compliance, and quicker reimbursement.
Final Thoughts Of Radiology Billing Services
Radiology billing services 2025 is changing with ever-increasing velocity by introducing additional new CPT codes, payer policies, and compliance guidelines. Practices that invest in precise documentation, coding audits, and automation will remain ahead of reimbursement headaches. Whether you bill in-house or outsource to Med Billing RES, an engaged billing strategy will keep your practice profitable, compliant, and audit-ready.
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info@medbillingres.com
