How to maximize revenue by using X-ray transportation codes?

Today, we’re going to speak about x-ray transportation codes. Portable diagnostic equipment is gaining popularity. These machines are reliable and affordable and they help businesses cut office service expenditures besides. Moreover, mobile diagnostic services are often more convenient for patients than scheduled visits and in some cases are the only way to reach patients. However, there is one issue — transportation costs.

Mobile imaging operators use vans or other vehicles to transport their imaging equipment. Sometimes they need to travel many miles and spend hours getting to a site. There are no problems if they can collect transportation fees directly from their patients, but when it comes to insurance reimbursement, issues may occur. Nevertheless, in some cases, the transportation costs of mobile imaging operators can be covered.

Medicare has contributed to solving this problem by the introduction of portable x-ray transportation HCPCS codes, intended for use by mobile providers when they travel to Skilled Nursing Facilities (SNFs). Generally, there are two codes, depending on the number of patients: R0070, for single-patient services, and R0075, when there are two or more patients. In addition, the R0075 code has five Level II modifiers: UN (two patients served); UP (three patients); UQ (four patients); UR (five patients); US (six or more patients). Imaging facilities are to report these codes to get their transportation costs covered, thereby making mobile x-ray services more accessible.

Still, there are some rules and considerations*:

• X-ray transportation codes are to be used for Skilled Nursing Facilities only. Transportation costs for trips to other types of facilities, e.g., doctors’ offices, may not be covered. For detailed information, please refer to the official Medicare booklet.
• Only portable x-ray procedures will be covered. Other diagnostic modalities (e.g., ultrasound or MRI) are not mentioned in coverage guidelines and Medicare only covers transportation to a different location, i.e., tests carried out in a facility with mobile x-ray equipment already on site will not be covered.
• Medicare covers transportation under these codes, but private payers may have their own rules. However, Medicare is one of the largest insurance programs in the United States. In 2016 it covered 16.7% of the total population and spent $696.6 billion on medical needs, and these figures are continuing to grow.
• The codes must be used correctly. Otherwise, insurance providers may deny claims. The R0070 code must be used for single-patient services, while R0075 requires one of the modifiers. Moreover, the transportation codes are to be combined with the Current Procedural Terminology (CPT) radiology codes (7000 series).
• Billing software should support x-ray transportation codes. Typically, mobile imaging operators use specialized software for sharing diagnostic images, preparing reports, billing, and sending insurance claims. Today, there are a lot of affordable, reliable, and user-friendly applications, but not all of them allow the use of transportation codes. Before signing up, it’s worth asking the software providers if this option is available. Usually, they willingly contact their customers, consult them on billing issues, and even create features customized to their needs.

Many medical businesses that deal with portable x-rays have increased their profits by using x-ray transportation codes. On top of that, they have expanded their service area considerably since Medicare covers their transportation costs.

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*This article is intended for information purposes only, so before using transportation codes, imaging operators are recommended to study the Medicare Claims Processing Manual and other related documents.

Links:

Medicare Coverage of Skilled Nursing Facility Care (official booklet): https://www.medicare.gov/Pubs/pdf/10153.pdf

Medicare Claims Processing Manual: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c13.pdf