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Reimbursement and appeals

SIR and its members are dedicated to improving public health through pioneering advances in minimally invasive, image-guided therapies, to include procedures for Y-90, lower extremity revascularization and mechanochemical endovenous ablation (MOCA).

Comment letters

SIR often submits comment letters to federal agencies, CMS and insurance carriers that specifically address interventional radiology treatments.

The following comment letters are available:

MIPS, APM and MACRA Coding

SIR is engaged with CMS as they develop codes for provider participation under the Merit Based Incentive Payments System (MIPS) and advanced Alternative Payment Models (APMs) Follow MACRA coding issues.

SIR submits comments to CMS on MACRA coding issues

In order to evaluate the resources used to treat patients for the new payment systems established under MACRA, CMS is required to establish care episode groups, patient condition groups and patient relationship codes that will be submitted on claims. SIR is engaged with CMS as they develop these codes for provider participation under the Merit Based Incentive Payments System (MIPS) and advanced Alternative Payment Models (APMs) and has submitted comments on two initiatives: 

See the SIR comments (Jan. 6, 2017) on patient relationship categories.

Patient relationship codes

Episode groups

Insurance letters archive

SIR works with members to draft “Comment Letters” to educate insurers about interventional radiology and the disease states that can be treated using interventional radiology in order to advocate for the needs of patients.

Recent letters to insurance companies will be available here.

In a letter, SIR joined other voices to express concern over Anthem's outpatient imaging policies.

Agency for HealthCare Research and Quality (AHRQ)

SIR comments to AHRQ on venous disease as part of multi-speciality coalition


Coverage letter templates

SIR has found that sometimes carriers deny reimbursement to the physician or the patient for specific interventional radiology treatments. The society has developed several examples  of common coverage request letters. Learn more and download templates.

Ask coding questions

Ask coding questions

Send your coding questions to SIR staff. This ensures that the details of your coding question do not get lost in translation from a phone message. 

Ask a question

Understanding Global Periods

Medicare established a national definition of a global surgical package to ensure that Medicare Administrative Contractors (MACs) make payments for the same services consistently across all jurisdictions. SIR has prepared references to assist physicians and administrators with common global periods for codes frequently reported by interventional radiologists. 

Learn more