High-Performance Radiology Billing & RCM.
Radiology billing services require mastery of the widest CPT code range in medicine — from plain film X-rays to interventional procedures — plus the -26/-TC billing decision that determines how much revenue a practice captures on every imaging study performed.
In radiology, the -26/-TC decision affects every single claim — and most practices get it wrong on at least some of their volume.
The professional component (modifier -26) and technical component (modifier -TC) split is foundational to radiology billing. When a radiologist reads a study performed at a hospital or freestanding imaging center that owns the equipment, only the -26 professional component is billable by the physician — the -TC goes to the facility. When a radiology practice owns its own imaging equipment and employs the technologists, both components can be billed globally (without modifiers) by the group. Getting this wrong in either direction — billing globally when only the professional component is warranted, or splitting when global billing applies — creates either an overpayment or a systematic revenue loss. The financial impact at volume is significant: an MRI of the brain (70553) billed globally generates roughly three times the revenue of the professional component alone. Our full RCM services ensure the right billing configuration on every study
Diagnostic Imaging CPT Code Ranges
The radiology CPT code structure spans: plain film X-rays (70000–76499), CT (70450–75635), MRI (70336–77084), ultrasound (76506–76886), and nuclear medicine (78000–79999). Within each modality, the correct code depends on the body part imaged, the number of views or sequences, and whether contrast was administered. A CT of the abdomen without contrast (74177), with contrast (74178), or both (74179) are three separate codes — and billing the wrong one based on the actual contrast administration is both a revenue error and an audit risk. Every code selection must match the documented imaging protocol.
Interventional Radiology: Diagnostic Plus Therapeutic
Interventional radiology introduces a second layer of coding complexity — the combination of diagnostic imaging and therapeutic procedure billing in the same session. Catheter placement codes (36200–36248), embolization (37241–37244), and image-guided biopsy codes (10005–10012) each carry their own rules about what's separately billable alongside a diagnostic study. NCCI edits apply extensively in IR — certain diagnostic imaging codes are bundled into interventional procedures and cannot be separately billed. Others are separately billable when a distinct diagnostic study preceded the therapeutic intervention. Getting the combination right requires understanding the procedural hierarchy, not just the individual codes.
Contrast Administration Billing
Contrast material may be separately billable beyond the imaging procedure code, depending on the payer and the setting. HCPCS A9xxx codes cover various contrast agents — A9579 for gadolinium-based MRI contrast, A9557 and related codes for iodinated CT contrast. Medicare generally bundles contrast into the imaging procedure payment; commercial payers vary. When contrast is separately billable, waste documentation for partially used vials is required. Practices that don't track contrast billing by payer type either miss the revenue on commercial claims or generate compliance risk by billing Medicare for a separately bundled service.
Mammography: Screening vs. Diagnostic
Screening mammography (77067 for bilateral digital mammography; 77063 for screening tomosynthesis) and diagnostic mammography (77065 for unilateral, 77066 for bilateral) are not interchangeable — and the distinction determines both reimbursement and patient cost-sharing. Screening mammograms are covered as preventive services (no cost-sharing under ACA for in-network commercial plans) while diagnostic mammograms fall under deductible and coinsurance. A patient who presents for a scheduled screening but is recalled for additional views has received a diagnostic study — and billing the encounter as screening generates both an incorrect claim and a patient billing error.
Happy Billing Benchmarks for Radiology:
98%+ First-Pass Clean Claim Rate
Radiology claims fail most often on incorrect -26/-TC application, wrong contrast code selection, and IR procedure bundling errors. We catch all three before the claim leaves our system.
-26/-TC Configuration Accuracy
Every radiologist’s billing configuration is reviewed against their practice arrangement — hospital-based, freestanding center, or practice-owned equipment — to ensure the correct component billing decision on every study type.
IR Procedure Code Fidelity
Every interventional radiology claim is reviewed against the procedural note for correct base code, add-on codes, and NCCI bundling rules before submission. No IR revenue is lost to a duplicate denial on a separately billable service.
A/R Under 35 Days
Radiology practices generate high claim volumes with a mix of routine diagnostic studies and complex IR procedures. Our 24/7 team works the full volume without letting any claim category age.
Our Specialized Process
Component Billing Configuration Audit
We review your billing configuration for each radiologist — physician-owned equipment vs. hospital-contracted vs. freestanding center — and set up the correct global vs. split billing structure from day one. No systematic component billing errors that leak revenue across thousands of monthly claims.
Modality-Specific Code Review
Every imaging claim is reviewed for correct CPT code selection — body part, number of views/sequences, contrast status, and modality-specific add-on codes — before submission. No more wrong-contrast-code denials or missing-views undercoding.
IR Procedure and NCCI Management
Every interventional radiology claim is reviewed against NCCI edit tables and IR coding guidelines for correct procedure-plus-imaging code combinations. Separately billable diagnostic studies are captured; bundled services aren't inadvertently double-billed.
Prior Authorization for Advanced Imaging
We manage prior authorization for CT, MRI, PET, and nuclear medicine studies — including ACR Appropriateness Criteria documentation when payers require it. No advanced imaging study moves to scheduling without a confirmed coverage path.
Built for High-Speed Imaging Workflows.
We work inside the imaging systems and EHRs that radiology practices and imaging centers rely on most. Our team is expert-certified in:
Epic Radiant | McKesson (PACS) | Sectra PACS | Athena Health | RamSoft
Frequently Asked Questins
How do you determine whether to bill globally or with a -26/-TC split?
The decision is based on who owns the imaging equipment and who employs the technologists. When a radiologist personally owns the equipment and the tech is their employee or contracted staff, global billing typically applies. When a radiologist reads studies at a hospital or independent imaging center that owns its own equipment and employs its own technologists, only the -26 professional component is billable by the physician. We confirm the correct configuration for every practice arrangement — and for radiologists who work at multiple sites with different ownership structures, we apply the right billing rule at each location.
What's your approach to prior authorization for advanced imaging like MRI and CT?
Can you handle billing for both diagnostic and interventional radiology in the same session?
How do you handle mammography billing when a screening converts to a diagnostic?
Do you handle billing for teleradiology services where the reading physician is in a different location than the imaging equipment?
Is your radiology revenue cycle lagging behind?
Radiology billing demands the same diagnostic precision you bring to your reads. Happy Billing’s radiology RCM specialists handle every code, component, and prior authorization so your revenue cycle performs as sharply as your imaging. For practices with overlapping referral networks, explore our Cardiology billing services, Orthopedic billing services, and Neurology billing services.