IR practices lose $42,000 to $85,000 a year to supervision documentation gaps, unbundled imaging guidance, and NCCI-edit failures — and OIG has flagged interventional radiology billing in three consecutive Work Plans.
Common Billing Challenges
These are the six billing failure points we see most often in IR practices — and the ones our team resolves systematically from day one.
Selective catheter codes get downcoded to non-selective 36200 when the operative report doesn't name the specific vessel at each level of selectivity — exactly what RAC auditors have targeted since 2023.
OIG found roughly 23% of sampled IR claims included imaging guidance codes that were bundled under NCCI edits and should not have been separately billed — each one a potential False Claims Act exposure.
Professional component claims get denied when the record doesn't confirm whether direct (level 2) or personal (level 3) supervision was met, especially in academic settings with resident involvement.
Billing a global code from a hospital outpatient setting, or missing modifier 26 when interpretation is sent to an outside group, creates duplicate billing errors or missed revenue.
Aetna, UnitedHealthcare, and Blue Cross plans require documented failed medical therapy, a fibroid mapping study, and gynecology consultation before approving UFE — missing any of the three adds 10 to 18 days to the auth timeline.
Practices that could bill globally from an office-based lab but don't are leaving the gap between $400-550 in professional-only revenue and $2,500-3,100 in global revenue per case on the table.
Key Procedure Codes
Our coders hold specialty-specific credentials and train continuously on the codes that drive the most revenue — and the most denials — in interventional radiology.
| CPT Code | Description | Common Issue |
|---|---|---|
| 36200 | Introduction of catheter, aorta | Non-selective; frequently over-assigned when selective placement wasn't documented |
| 36215 | Selective catheter, first order branch | Requires the named vessel in the operative report |
| 36216/36217 | Selective catheter, second/third order branch | Downcoded to 36200 without vessel-level documentation |
| 77001 | Fluoroscopic guidance, central venous catheter | NCCI bundling violation when billed with 36555/36556/36560/36561 |
| 75894 | Transcatheter embolization, S&I | Included with 37241-37244; never billable separately |
| Modifier 26/TC | Professional / technical component split | Global billing only valid when one entity performs both components |
Why Rcmaxis
We're not a generalist billing service that added a specialty module. Our team is built around specialty-specific expertise.
Every coder on your account holds the specialty coding credential relevant to interventional radiology — not a generic CPC only.
Significantly above the 23% imaging-guidance unbundling rate OIG found across sampled IR claims. Fewer rejections means faster payment and less write-off risk.
Full EHR integration, payer enrollment verification, and charge capture setup in 2 weeks — with zero disruption to your surgical schedule.
One point of contact who knows your practice, your payers, and your billing history — available for weekly calls and monthly performance reviews.
Month-to-month engagement. We earn your business every month by improving your collections — not by locking you in.
Live visibility into your collections, denial rate, aging AR, and payer performance — updated daily, reviewed monthly with your account team.
Straight answers to what practices usually ask before they switch.
Free revenue assessment for qualified practices. We audit your last 90 days of claims, identify every revenue leak, and show you a clear path to better collections — at no cost.