Prior Authorization for Interventional Radiology Procedures
Prior authorizations for Interventional Radiology (IR) procedures remains unpredictable. Payers frequently outsource reviews to TPAs such as eviCore, AIM, or Carelon – often switching without notice. Rules vary by plan, and reviewers are often non-specialists.
Medicare Update: Telehealth and Claims Processing During the Government Shutdown
Effective October 1, 2025, The Centers for Medicare & Medicaid Services (CMS) has released an update on Medicare operations during the current government shutdown. Two key areas affect providers: Temporary Claims Hold CMS has directed all Medicare Administrative Contractors (MACs) to implement a temporary hold on claims for up to 10 business days. This is […]
Cigna’s New Reimbursement Policy: E/M Code Downgrades
Beginning October 1, 2025, Cigna will implement a new Evaluation and Management (E/M) reimbursement policy (Policy R49) that allows for the automatic downcoding of high-level E/M services.
Key Diagnostic Radiology, Interventional & ASC MPFS Changes for 2026
This proposal delivers the most extensive set of Diagnostic Radiology, Interventional & ASC MPFS Changes in several years, covering both professional reimbursement and site-of-service adjustments.
Become a Great Radiology & Interventional Radiology Boss: A Simple (But Not Always Easy) Guide (Part 2)
In every thriving company, there’s usually a great boss behind the scenes; someone who leads with purpose, manages with clarity, and creates a workplace where accountability and engagement go hand-in-hand. In the fast-paced world of Radiology & Interventional Radiology practices, that often means building and leading multidisciplinary teams of physicians, APPs, nurses, technologists, and administrators towards a shared goal of sustainable, compliant, and compassionate patient care.
Y90 Billing in the OBL: Navigating the Maze of Dose Reimbursement
Billing for Yttrium-90 (Y90) radioembolization procedures in an Office-Based Lab (OBL) is one of the most complex challenges in interventional radiology revenue cycle management. There is no one-size-fits-all answer.
CMS Medicare Advantage Audit Expansion
On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a Medicare Advantage (MA) Audit Expansion.
Interventional Radiology RUC Survey Launch – June 13
The Society of Interventional Radiology (SIR) has announced that RVS Update Committee (RUC) surveys will be sent starting June 13, 2025, to randomly selected SIR members.
Become a Great Radiology & Interventional Practice Boss. A Simple (But Not Always Easy) Guide (Part 1)
In every thriving Radiology & Interventional practice, there’s usually a great boss behind the scenes; someone who leads with purpose, manages with clarity, and creates a workplace where accountability and engagement go hand-in-hand. Becoming a great boss comes down to mastering two key roles: Leadership and Management.
CPT 2026: Major Radiology & Interventional Coding Updates
Coming soon – CPT 2026: Major Radiology & Interventional Coding Updates. The 2026 CPT code set includes the most extensive Radiology and Interventional coding updates in years. These CPT code updates will significantly impact clinical documentation, coding workflows, and billing systems.