Are You Maximizing Claims on Radiology, Pathology, and E/M Services?

Date-of-services rules can be cumbersome on a good day—and can even turn an otherwise good day into a major headache for coders. A Medicare administrator contractor (MAC) put forth a provider outreach and education (POE) recommendation recently aimed at leveling out that “uphill battle” when it comes to complying with date-of-service requirements. An article in published online by DecisionHealth recommends clarifying the specific date-of-service rules your urgent care center follows when reporting common radiology, pathology, and E/M services in order to ensure you’re reaping the highest possible reimbursements—and reduce your rate of rejected claims. That means working closely with payers at the local level to get clear direction as to what’s required (eg, noting the timeframe an x-ray was taken vs the day a physician read the image). The article goes on to recommend that you get policies in writing. As always, it also makes sense to work closely with your billing and coding partners.