decisionhealth Newsletters, Part B News - 2007 Issue 10 (October)
Ask carrier to fix radiology claims incorrectly denied
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Article Overview
This article covers a Medicare radiology claims payment issue affecting certain technical component claims that were denied under a carrier edit and later reinstated by CMS. It is aimed at billing and coding professionals who manage imaging claims and need to understand the scope of the temporary processing change, the related CMS transmittals, and how to recognize potentially impacted claims for carrier review.
Why This Topic Matters
The topic matters because some legitimate imaging claims may have been denied during a temporary Medicare processing edit, creating the need for claim review and correction. Readers working with radiology billing can use the article to understand the general nature of the issue and whether their own claims may be affected.
What You Will Learn
- The general Medicare claims processing issue affecting certain radiology services
- How temporary carrier edits can lead to incorrect denials
- What types of claims may warrant follow-up review
- How CMS transmittals relate to changes in claims processing guidance
Who Should Read This
- Radiology coders
- Medical billers
- Revenue cycle staff
- Compliance staff
- Practice managers
Codes Discussed
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