General Surgery Coding Alert - 2018 Issue 4
Compliance: Zone in on these Diagnostic Imaging Order Form Guidelines
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Article Overview
This compliance-focused article explains how diagnostic imaging orders are handled in an IDTF setting under CMS guidance. It is intended for coders, billers, office managers, and imaging providers who need a broad understanding of order documentation, communication methods, revisions, and limited exceptions that can affect workflow and compliance.
Why This Topic Matters
Diagnostic imaging ordering practices can affect claim compliance, documentation integrity, and whether additional testing is appropriately supported. The article helps readers recognize the general categories of Medicare guidance that govern order processing and provider communication.
Article Sections
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Defining an Order Form
Introduces Medicare’s general concept of an imaging order and the main ways an order may be communicated to a testing facility. It also notes related documentation considerations for certain clinical diagnostic tests.
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Know these Rules Surrounding Order Changes, Reorders
Discusses when changes to an imaging request may require a new order and outlines a limited exception involving additional diagnostic testing. It also references a specific mammography-related circumstance.
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Take these Steps when Ordering Provider is Unreachable
Summarizes the conditions Medicare describes when a testing facility cannot obtain a revised order from the treating provider. The section focuses on general criteria tied to additional testing and documentation.
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Additional Rules for Changes to Diagnostic Testing
Reviews broader categories of changes an interpreting physician may make to an imaging exam and notes a limitation tied to patient setting. It also addresses whether provider notification is required in these situations.
What You Will Learn
- How Medicare broadly defines an imaging order
- Which general communication methods are described for sending orders
- When a revised request may be needed for diagnostic imaging changes
- What limited exceptions may allow additional diagnostic testing
- What types of exam adjustments are discussed in the article
- Which compliance considerations apply to certain non-hospital diagnostic testing settings
Who Should Read This
- Medical coders
- Billers
- Office managers
- Diagnostic imaging providers
- Radiology compliance staff
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