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Radiology billing for imaging centers, teleradiology, and hospital-based reads

Radiology billing is a split game: technical component, professional component, global. Miss the split and one side denies. We bill to the contract and the site of service.

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Where radiology practices lose revenue

We see the same patterns across radiology groups. The leaks are specific, recurring, and fixable with coding discipline and payer-aware claim construction.

  1. TC vs 26 vs global billing based on ownership
  2. Multiple procedure reduction (MPR) on same-session imaging
  3. Teleradiology billing with PAR and payer restrictions
  4. Contrast vs non-contrast vs with-and-without (CPT selection)
  5. Interventional radiology procedure coding
CPT specimen sheet

High-volume Radiology codes we code and appeal

Not a complete list. A representative slice of the codes that drive revenue and denials for radiology practices.

CodeDescriptionProfile
70553MRI brain with and without contrastHigh volume
74177CT abdomen and pelvis with contrastModifier-sensitive
76700Abdominal ultrasound, completeDenial-prone
77067Screening mammography, bilateralHigh volume
77066Diagnostic mammography, bilateralModifier-sensitive
36561Insertion of central venous portDenial-prone
75710Angiography, extremityHigh volume

How we run radiology billing

TC, 26, or global billed based on ownership and contract. MPR applied on secondary procedures. Teleradiology billing coordinated with originating site agreements. Contrast administration coded separately when payer allows.

Why it matters Radiology practices win or lose on coding precision at the line-item level. Generalist billers average 8 to 12 percent revenue leakage on specialty-specific edge cases. Our coders run only specialty books, so the edge cases are the book.

What the common denials look like and how we fix them

Pattern we see. TC or 26 split errors on hospital-based practice, MPR not applied triggering audit, and contrast denial without medical necessity for the with-and-without study.

How we fix it. Every denial is logged against its CARC/RARC code and routed to a coder who owns the appeal. We rebuild the claim with the documentation the payer is actually asking for, not a generic reconsideration letter. Recovery rate on appealable radiology denials averages above 60 percent.

Services for this specialty

Where to go next

Pick a thread and keep pulling. Every engagement starts with the piece that has the biggest revenue leak.

ServiceMedical BillingServiceCredentialing & EnrollmentServiceMedical CodingServiceRevenue Cycle Management
How do you handle professional vs technical split?
Based on ownership of the equipment and facility. If the practice owns the scanner, global or TC. If reading a hospital or imaging-center film, professional only (modifier 26). We audit the claim to match the actual setup.
Do you handle teleradiology?
Yes. PAR and state licensure tracked. Some payers restrict teleradiology billing by originating site. We coordinate with the contracting team.
Do you handle interventional radiology?
Yes. IR procedures (vascular access, biopsy, embolization, angioplasty) with the technical and professional split, supply codes, and the contrast and catheter HCPCS codes most IR practices miss.
Can you bill teleradiology across state lines?
Yes. Teleradiology requires licensure in the state where the patient is located. We verify licensure by state, bill to the appropriate state payer rules, and handle the cross-state compliance documentation.
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See what radiology billing could actually look like.

A written 30-day diagnostic. Dollar figures against every finding. No obligation.

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