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    The 5 biggest misconceptions about imaging coding and reimbursement


    Standards are met by producing an image

    Before a claim is sent, the following criterion should be met and documented in the clinical record to support the claim submitted to the carrier:

    • The doctor must assess the patient and order the image be taken based on medical necessity (not just because the patient’s insurance will pay for the image
    • The image must be taken and the resulting image must be of diagnostic quality
    •  Finally, the doctor must assess the radiographic and note the findings

    Trending article: The top 10 things you need to know about ICD-10

    Size doesn’t matter

    With the advent of the digital radiographic revolution, the images produced are not limited by the film size. In the past, radiographic films were produced in uniform sizes. Today, with the advent of digital images and the software that can help produce the images, the image produced may not be of a conventional size. Take for example the elongated BW images that can be produced by some of the technologies. The BW codes are specific about number and silent about the size of the image generated. In our example of the elongated BWs generated by some of the newer technologies, two images are produced, one for the right and one for the left. Although these elongated images generally contain the same information that four conventional bitewings contain, only two were taken. These images would be submitted as two bitewings, not four bitewings.

    Continue to page three for more...

    Dr. Roy Shelburne
    Dr. Shelburne, an honor graduate from VCU’s dental school, opened a private general practice in Pennington Gap, Va., in 1981. In 2008, ...


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