From coding and reimbursement to quality improvement, the Society of Interventional Radiology (SIR) offers a collection of resources designed to help physicians navigate challenges and opportunities in this new era of health care. SIR also provides tips and advice for real-world issues facing today's medical practices.
SIR Revenue Cycle Management Course
The 2023 IR Revenue Cycle Course aims to educate IR physicians on the revenue cycle. Medicare policies and how it applies to IR practices. The different payment methods applied for reimbursement are based on your practice type. How devices are bundled into IR procedures or packaged in the overall reimbursement, and how your contract with the facility and payers plays into reimbursement for IR services. Additionally, the course educates on how insurances determine policy around coverage, prior authorization, coding, payer edits, denials, appeals, and how codes are created. Lastly, the course teaches measuring and increasing revenue for IR services. Available in the IR store.
The 2023 edition of the Interventional Radiology (IR) coding update is a valuable resource that provides information essential to coding and billing IR services correctly. The 2023 coding resource outlines the rules, guidelines, and systems in place that govern how coding should be done. In addition, this vital reference contains changes in CPT 2023 codes, procedures frequently performed with practical coding guidance in each section, common coding questions, and charge sheets to help capture chargeable services. The 2023 edition is available in an electronic format for easy navigation. SIR members can access the e-publication for free. Non-members can also access this resource at a fee. Visit the IR Business Center.
The Navigator® coding guides, created by the industry experts at Revenue Cycle Coding Strategies, are full of clinical scenarios, authoritative guidance, and expert advice to ensure your documentation and coding leads to accurate claims and less hassle due to denials. SIR members can receive 20% off the following titles:
2023 Navigator® Interventional Radiology Procedures: This manual is a comprehensive reference guide for interventional procedure coding. For each interventional procedure, the manual explains procedure technique, coding guidelines (including references), documentation requirements, bundling rules, and coverage limitations. The guide also explains Medicare reimbursement policies like the multiple procedure payment reduction (MPPR) rules and the correct coding initiative. This is the only interventional coding guide you will need to buy!
2023 Navigator® Evaluation and Management Services for Radiology: This reference manual will help you cut through the confusion that surrounds radiology evaluation and management (E/M) services and determine when it's appropriate to report an E/M code and which code to report. If your radiology practice currently bills for E/M services, or is thinking of billing for them, this book is a must-have.
IPPS proposed rule FY 2024
On April 10, 2023, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for fiscal year (FY) 2023 inpatient prospective payment systems (IPPS). The full document can be accessed here.
For FY 2024, which begins October 1, 2023, CMS is proposing to increase payment rates for hospitals that have successfully participated in the Hospital Inpatient Quality Reporting (IQR) Program and are meaningful electronic health record (EHR) users by approximately 2.8 percent. This is reflected in the projected hospital market basket update of 3.0 percent and a 0.2 percent reduction of the productivity adjustment.
The SIR Economics Steering Committee reviewed the proposed rule and provides a detailed summary for members below.
Coding application and guidance
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. Ask your coding question here
NEW: SIR's coding application and guidance workgroup have updated our IR E/M coding audit, E/M instructions, and global day worksheets. Click on the links below to use these documents in your IR practice.
CPT® Editorial Panel and RUC
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. For more information click here.
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. Click here for more information.
Coding and reimbursement digest
SIR has started a new initiative which is to provide a high-level summary of our most up-to-date content on coding and reimbursement. Starting in October 2021, SIR staff has been posting monthly digests about upcoming conferences, training, events, coding changes, billing changes and other relevant IR topics. Read more
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, in the case of IR, allows billing for evaluation and management codes. The SIR Economics Committee urges all IRs to verify with all of your insurance carriers that you are registered as code 94—interventional radiology.Code properly for IR
Advancing all practice models
Navigating practice management, quality requirements, safety guidelines and reimbursement just became a lot easier. Knowledge of new guidelines, government regulations, safety requirements and quality requirements is paramount to success for today's physician in the global healthcare environment.
Supporting all practice models
SIR supports greater patient access to IR care and an IR’s ability to thrive in his or her chosen practice model. Members of the Private Practice Advisory Committee support the development and distribution of toolkits and resources that support members in building high quality, successful IR practices.
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.