Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
If you're a Find-A-Code subscriber, there's no need to worry. Find-A-Code's fee calculators are ready for the change. You can count on Find-A-Code for the most complete and accurate information you need as a medical coder/biller.
Radiology: Learn These Rules for Diagnostic vs. Screening Mammography
Tip: Extra views don’t automatically change your coding.
Facilities sometimes have policies stating that the staff should automatically get extra views when a patient with a history of breast cancer comes for a mammogram. The question for coders is: Do the extra views mean the exam is diagnostic even if the patient presents for a screening?
The short answer: Routine performance of extra views for patients with a history of breast cancer is not sufficient to support coding a diagnostic mammogram (77055, Mammography; unilateral or 77056, … bilateral) rather than a screening (77057, Screening mammography, bilateral [2-view film...
To read the full article, sign in and subscribe to tci Outpatient Facility Coding Alert.
TCI's Outpatient Facility Coding Alert helps your facility stay profitable by covering issues that are important to you — everything from billing strategies and appropriate payment indicators to coding tips and tricks, analysis of industry trends, and so much more. Subscribe today and let our experts make your job easier.
Current newsletters added each month
Fully searchable archives - over 650 articles
ALL years/issues back to 2012 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.
Quick, Current, Complete - www.findacode.com