Imaging bundled with procedure
A separate guidance or S&I code was billed with a procedure that already includes it. Core MB holds a bundle map per code family and strips included imaging before the claim leaves.
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Interventional radiology medical billing services
Interventional radiology billing depends on reading the procedure note the way the code set does: which vessels were selected, which imaging was bundled, what guidance was documented and whether sedation was separately reportable. Most modern IR codes bundle catheter placement, imaging and intervention together, so claims pay when the coder knows what each bundle already includes.
What makes interventional radiology billing different
IR coding is built on bundles, vascular families and guidance rules that have changed repeatedly, and payers audit all three.
- Lower extremity revascularization codes 37220 through 37235 and dialysis circuit codes 36901 through 36909 bundle catheterization, angiography and intervention per vessel territory, so separately billing 36245 selective catheter placement or 75710 angiography with them triggers NCCI edits.
- Cerebral angiography uses 36221 through 36228 by vessel selected, and additional vascular families require modifier 59 or XS with documentation of a separate access or a distinct diagnostic purpose, not just a different catheter position.
- Image-guided drainage under 49405 through 49407, biopsies with guidance such as 10005 through 10012 and 19083, and venous access codes 36556, 36569 and 36572 all include the imaging, so 76942 or 77012 is not billed alongside them.
- Moderate sedation is billed separately with 99152 and 99153 when the IR physician supervises it and intraservice time is documented, and 76937 for ultrasound vascular access needs a permanent image and a note on vessel patency.
Denials we see most in interventional radiology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Separate family not supported
A second catheterization billed with modifier 59 was denied because the note did not show a distinct vascular family or access. Core MB reviews the procedure note for vessel selection before applying the modifier.
Sedation time undocumented
99152 was denied because start and stop times or the independent observer were missing. Core MB checks the sedation record for intraservice minutes and observer name before billing any sedation unit.
How Core MB bills for interventional radiology
Core MB assigns coders who work from the full procedure report, not the order, and who know which IR code families bundle access, imaging and intervention. Credentialing for new interventional radiologists runs in the same client portal. Credentialing for new providers runs in the same system, tracked live in your client portal.
- Every procedure note is coded from vessel selection, access site and documented guidance, with the bundle map applied before submission.
- Modifier 26 is applied for hospital-based professional claims and global billing is used only at office-based labs and ASCs.
- Office visits with 25 and decision-for-surgery visits with 57 are checked against the global period of each procedure.
Everything in the service
Core MB provides verification, authorizations, coding review, scrubbing, follow-up, denials, posting, AR, statements and reporting for interventional radiology groups, with credentialing in the same portal.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Interventional radiology billing questions
When can we bill a diagnostic angiogram with an intervention?
Only when the diagnostic study is a true decision point: no prior catheter angiography, a prior study that was inadequate, or a changed clinical picture. The note must say so. Core MB appends modifier 59 or XU only when that language is present and otherwise codes the intervention alone, because payers audit this combination closely.
Our office-based lab claims are paid but the hospital claims are not. Why?
Hospital claims need modifier 26 for the professional component and sometimes a different NPI or place of service than the office lab. Core MB sets place of service, modifier and billing provider by site in the practice management system so the same physician's work bills correctly in both settings.
A dialysis access patient had angioplasty and a stent in the same circuit. What is billable?
The dialysis circuit codes 36901 through 36909 are hierarchical. A stent in the peripheral segment is 36903, which includes the angioplasty and the diagnostic fistulogram. A central venous stent is added with 36908. Core MB codes the highest applicable level once and adds central segment work only when documented.
How do we get started with Core MB for interventional radiology billing?
Submit the quote form with your sites of service, procedure mix and payer list. We review a sample of procedure reports and claims, set a start date, and run the transition alongside your current billing so nothing stalls. Credentialing for new interventionalists can start at the same time.
More in diagnostics
IR billing by coders who read the whole procedure note
Core MB turns complex interventional radiology reports into correctly bundled claims, defends modifier use with documentation and keeps hospital and office claims paying.