Health policy, economics and coding

Health policy and economics

The SIR economics committee is dedicated to demonstrating interventional radiologists’ value to the healthcare systems. Our team interfaces with payers on proposals to update payment rates, policies and regulations preventing patient access to care. In addition, the economics committee offers resources designed to help physicians navigate challenges and opportunities in this new era of health care.

Health Policy Actions

Carrier advocacy

SIR carrier advocacy workgroup prevents the enactment of interventional radiology coverage policies and abet modification of coverage policies that adversely affect SIR members. Our team develops evidence-based letters to help overturn carrier policy, denied authorizations, denied claims and comment letters to purposed payor policies.

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Coding and reimbursement

SIR coding application and guidance workgroup are devoted to eliminating barriers in IR billing by providing coding guidance to SIR members. Our team constructs IR educational content to stimulate the demand for high-quality billing by increasing the value of SIR member resources.

SIR CPT® Editorial Panel and RUC Workgroup oversee and execute interventional radiology CPT® and RUC development. Our team works with the AMA and CMS to ensure that IR CPT® codes reflect the latest medical care available to patients while safeguarding the work of IR physicians by ensuring physician work is properly reflected through the RUC process.

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Improper specialty designator for IR could impact future reimbursement

Is your practice using the correct specialty code to capture your work as an interventional radiologist? The Healthcare Provider Taxonomy Code identifies specialties for service providers in insurance claims. Appropriate use of specialty codes reduces inappropriate suspensions, improves the quality of the utilization data, and allows billing for evaluation and management codes in the case of IR. Therefore, the SIR Economics Committee urges all IRs to verify with their insurance carriers that they are registered as code 94—interventional radiology. Learn more

CODE PROPERLY FOR IR

Value of IR

When patients are treated by an IR, the benefits of this specialized care extend beyond the patient. With less-invasive treatments, the overall cost of care to hospitals and insurers can be substantially reduced. The benefit of reducing costs while providing high-quality outcomes aligns with risk-based payment models, making IR treatments well-positioned for the shift to value based care.

Health policy, economics and coding

Health policy, economics and coding

Patient center

Member central

Advocacy

Corporate relations

Practice resources

Meetings and Education