RADIOLOGY: Stay on Your Toes to Keep Imaging Claims on the Straight and Narrow

Why This Topic Matters

Imaging claims are a frequent audit target, and small reporting choices can affect coverage, medical necessity review, and claim payment. The article helps readers identify the major policy and coding areas that can influence whether radiology claims are accepted, denied, or challenged.

Article Sections

1. OIG scrutiny of advanced imaging claims

   Introduces the report prompting increased attention to advanced imaging billing and describes the general compliance context for radiology practices.

2. Screening mammography scenario

   Covers a common mammography billing situation and the related diagnosis-reporting and coverage concerns discussed in the article.

3. When a radiologic exam diagnosis is unclear

   Discusses diagnosis selection for an x-ray or similar exam when the ordering reason is uncertain and highlights the importance of knowing the clinical context.

4. DEXA scan billing considerations

   Reviews a dual-DEXA ordering scenario and the payer concerns associated with reporting multiple bone density studies.