Radiology Billing Services for Imaging Centers and Radiologists

Radiology billing services have to match hospital reads, outpatient scans, mammography, and interventional cases to separate payment rules. Pyramids Global connects every imaging study back to its original order.

CONSULT OUR TEAM ON RADIOLOGY BILLING

Radiology Billing Services That Start With
the Imaging Order

Radiology billing services rely on details that sit outside the reading room. Every study begins with an order from another physician, and that order’s diagnosis, NPI, and approval shape whether the claim is paid. A radiologist may read a CT for a hospital in the morning, interpret mammograms from an outpatient center at noon, and perform a guided biopsy later in the day. Pyramids Global’s certified coders link each final report to its order, setting, and payer, so the claim mirrors the imaging your group actually performed.

Radiologist reviewing CT images at a reading workstation

Why Radiology Claims Follow Rules Most
Specialties Never Meet

Technologist preparing a patient for an MRI scan in an imaging center

Imaging claims carry rules that most specialties never see. A hospital-based radiologist bills only the read with modifier 26, while a freestanding center bills the global service or reports the equipment side with modifier TC. Under Medicare’s multiple procedure payment reduction, the technical component of each additional CT, MRI, or ultrasound study on the same patient in the same session is reduced by 50%. ICD-10-CM outpatient guidelines do not allow coding “rule out” or suspected diagnoses, so signs and symptoms are reported instead. Medicare also denies imaging claims when the ordering provider is not enrolled in Medicare through PECOS.

Billing specialist matching imaging orders to claims on a computer

Radiology Revenue Leaks Imaging Groups Face
and How Each Is Handled

Imaging groups process large daily volumes, so a gap that looks minor on one study can repeat across hundreds. These four problems often lead to radiology denials:

Missing or Mismatched Orders

When the ordering physician’s NPI is missing, unenrolled, or the order names a different study than the one performed, payers deny the claim. Contrast use or body part changes made at the scanner create the same problem. Our coders compare each report to its order and flag mismatches for correction before submission.

Weak Diagnosis Support

Orders often list vague reasons or uncertain diagnoses that cannot be coded for outpatient studies under ICD-10-CM rules. Without signs, symptoms, or findings from the report, medical necessity edits deny the claim. We code from the final report and the order together.

Imaging Approvals Left Open

MRI, CT, PET, and nuclear studies often need approval through a radiology benefit manager, and the approved code must match the study done. A switch to a with-contrast study can void the approval. We check every authorization against the scan on the day of service.

Component and Modifier Errors

Billing globally when only the interpretation was performed, or leaving off modifier 26 or TC, results in denials or payment takebacks. Same-session studies also need correct sequencing so payment reductions apply properly. Our team matches each claim to the facility arrangement first.

From Imaging Order to Final Payment:
Our Radiology Billing Steps

We follow each study from scheduling and eligibility checks through the scan, the signed report, coding, claim release, payer response, underpayment review, and the patient’s final balance.

Diagnostic and Interventional Coding

Our certified coders select CPT codes for X-ray, CT, MRI, ultrasound, nuclear medicine, mammography, and image-guided procedures, take contrast and laterality details from the report, and apply modifiers 26 and TC where components are split.

Eligibility and Authorization
Review

Before the scan, we verify coverage, check whether the payer or a radiology benefit manager requires approval, and confirm that the approved CPT code and contrast match the scheduled study, so changes made at the scanner are caught early.

Imaging Denial Management and Appeals

Each denied imaging claim is reviewed, corrected with order and report details, and refiled or appealed. Recurring issues, grouped by referring practice or by payer, are listed for your office at month end.

Radiologists Focused on Reading Studies

Radiologists face growing study volumes and tight turnaround expectations. Handing claims and payer calls to our staff lets your radiologists and technologists stay focused on image quality, accurate reads, and timely reports.

Why Imaging Centers and Radiology Groups Rely
on Pyramids Global

Since 2013, Pyramids Global has supported more than 500 practices across 20+ specialties. Hospital radiology groups, freestanding imaging centers, and teleradiology practices value these parts of radiology billing services:

Coders Focused on Imaging Codes

Diagnostic, interventional, nuclear, and breast imaging codes are routine for our certified imaging coders, along with contrast rules, payment reductions, and yearly CPT changes.

A Single Point of Support

An assigned account manager learns your radiologists, reading sites, and payer contracts, giving staff one familiar person for claim, approval, and referral questions.

Multi-Facility Reading Support

For groups reading across hospitals and outpatient centers, we track each facility’s billing arrangement, place of service, and component split, so each read is billed under the right arrangement.

Reports by Modality and Site

Each month, you see collections, top denial causes, aging balances, and study volume by modality, radiologist, and facility, helping leaders review payer trends.

Client Account
Averages

Across our client accounts, we average 98% coding accuracy, 99% first-pass claim acceptance, and 86% of collections within 30 days.

Keeping Each Imaging Study Claim Accurate

A radiology claim depends on three documents: the order, the final report, and the payer’s rules. Before submission, our coders compare CPT codes, modifiers, contrast use, laterality, and diagnosis codes against those sources for every radiology study, which helps keep one repeated error from affecting many claims.

Imaging groups that rely on our radiology billing services get coding rationale in writing, a monthly look at payer and referral trends, and documentation arranged for audits or payer requests. Billing stays consistent across diagnostic imaging, breast imaging, interventional procedures, and teleradiology reads.

Pyramids Global coding team checking radiology billing services data

Radiology Billing Services Paired With Related Support

Imaging income also hinges on correct coding, quick approvals, and up-to-date enrollment for every reading radiologist, and the American College of Radiology shares coding and practice guidance that many groups use for documentation. Our radiology billing services connect with:

- Certified coding for diagnostic imaging, mammography, nuclear medicine, and interventional cases

- Prior authorization services for MRI, CT, PET, and nuclear studies, typically initiated within 30 minutes of receiving the order

- Credentialing services for radiologists in Medicare, state Medicaid, and private insurance networks across 21 states, often 60 to 120 days

- Premium Practice Audit covering modifiers, order matching, and imaging payment reductions

Radiology Billing Services: Common Imaging Questions Answered

How is pricing decided for radiology billing services?

Fees reflect your monthly study count, the plans your patients carry, and which services you select. You are not charged a setup fee, and our staff covers the details during a free consultation for your group.

Which imaging studies and procedures do you bill?

We bill professional, technical, and global imaging services across X-ray, CT, MRI, ultrasound, nuclear medicine, PET, and mammography. We also bill interventional radiology, image-guided biopsies, 3D rendering, and teleradiology reads for multiple facilities.

How are screening and diagnostic mammograms coded for payers?

Screening mammograms use 77067, while diagnostic mammograms use 77065 for one breast or 77066 for both. For Medicare, screening tomosynthesis is added with 77063, and diagnostic tomosynthesis is reported with G0279 alongside the diagnostic code.

How long do MRI and CT prior authorizations usually take?

Requests are typically initiated within 30 minutes of receiving the order. Payers usually decide urgent requests in 24 to 72 hours, while standard reviews often take 7 to 14 business days.

Will our imaging center need a new RIS or PACS?

No, billing happens within the EHR, RIS, or practice management software your center already runs. A BAA is signed with each imaging client before work begins, and patient images and data follow HIPAA standards.

How will we see billing results after onboarding?

A monthly report shows collections, denials, outstanding balances, and study volume by modality, radiologist, and site for side-by-side review.

Schedule a Free Radiology Billing Consultation
for Your Group

Women's health practice manager reviewing reports with a billing advisor

Order mismatches, unapproved MRI studies, or missing modifiers point to gaps in imaging billing. We start radiology billing services by comparing recent claims with orders and denial patterns. Since 2013, Pyramids Global has supported more than 500 practices across 20+ specialties, and a free consultation is the first step to see where your imaging claims stand.

Our team can handle imaging coding, eligibility and authorization checks, claim submission, payment posting, underpayment follow-up, and appeals across every facility you read for. This gives your radiologists and technologists more time for accurate reads and timely reports.

CONSULT US FOR A RADIOLOGY BILLING REVIEW