Medical Coding: Types of Radiological Services – Guidelines and Tips
Radiological services are a critical part of medical diagnosis and treatment. Accurate coding of these services ensures proper reimbursement, regulatory compliance, and clean claims processing. Medical coders must understand the different types of radiology procedures, how they are categorized, and the specific documentation requirements to code them correctly.
Common Types of Radiological Services
Radiology services are reported using the CPT code range 70010–79999 and are generally divided into diagnostic, interventional, and nuclear medicine imaging.
Diagnostic Radiology
These services create images of internal body structures to help diagnose medical conditions. Common types include:
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X-rays – Used to evaluate bones, chest conditions, and soft tissues
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CT scans (Computed Tomography) – Cross-sectional imaging for trauma, tumors, and internal bleeding
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MRI (Magnetic Resonance Imaging) – High-resolution imaging of soft tissues, joints, brain, and spinal cord
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Ultrasound (Sonography) – Real-time imaging using sound waves, often used in obstetrics, cardiology, and abdominal studies
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Mammography – Breast imaging for screening and diagnostic purposes
Interventional Radiology
These procedures use imaging guidance to perform minimally invasive treatments. Examples include:
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Image-guided biopsies
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Angiography
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Vascular stent placements
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Embolization procedures
Interventional radiology typically involves both a surgical CPT code and an imaging supervision and interpretation (S&I) code, when applicable.
Nuclear Medicine
These services use radioactive materials to evaluate organ and tissue function. Common procedures include:
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PET scans (Positron Emission Tomography)
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Bone scans
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Thyroid uptake and imaging studies
These are reported using CPT codes in the 78000–79999 range.
Key Coding Guidelines for Radiological Services
Review Complete Documentation
Always verify:
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Order from a qualified provider
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Medical necessity documented in the medical record
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Final radiology report signed by the interpreting physician
Incomplete documentation can lead to claim denials or audits.
Distinguish Between Professional and Technical Components
Radiology services often have two billable parts:
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Professional component (Modifier -26) – Physician’s interpretation and report
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Technical component (Modifier -TC) – Equipment, supplies, and technical staff
Use global billing only when the provider performs both components.
Use Modifiers Correctly
Common modifiers for radiology coding include:
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–26 Professional Component
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–TC Technical Component
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–59 Distinct Procedural Service (when appropriate and supported by documentation)
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–RT / –LT Right or Left side
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–76 Repeat Procedure by the Same Physician
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–77 Repeat Procedure by Another Physician
Follow Bundling and Unbundling Rules
Refer to the National Correct Coding Initiative (NCCI) edits:
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Many radiology procedures are bundled with contrast administration
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Post-processing and 3D reconstructions may or may not be separately billable depending on documentation
Avoid unbundling services that are considered integral to the primary procedure.
Medical Coding Bundling and Upcoding
Code Contrast Usage Properly
Determine whether the study was:
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Without contrast
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With contrast
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Without and with contrast
Choose the correct CPT code based on the final performed service, not just the original order.
Apply Medical Necessity Standards
Radiological services must be supported by:
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Symptoms
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Signs
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Working diagnoses
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Physician assessment
Ensure the ICD-10-CM codes match the reason the imaging study was performed.
Tips for Accurate Radiology Coding
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Always code from the final radiology report, not the order.
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Pay close attention to body part, laterality, and number of views.
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Verify the use of contrast agents and the route of administration.
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Confirm the presence of supervision and interpretation documentation for professional billing.
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Stay updated on annual CPT and Medicare changes.
Common Radiology Coding Errors to Avoid
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Billing both global and component services incorrectly
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Missing or incorrect modifiers
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Coding from the radiology order instead of the final report
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Improper unbundling of imaging services
Accurate medical coding for radiological services supports proper reimbursement, reduces denials, and ensures compliance. By understanding the types of radiology services and following established guidelines, medical coders can improve accuracy and efficiency in their coding processes.
Understanding Radiology Medical Coding: Key Concepts and Practices