SIR 2024
General IR
Sara Silberstein, MD, MS (she/her/hers)
Integrated IR/DR Resident Physician, PGY2
Jefferson Einstein Hospitals
Financial relationships: Full list of relationships is listed on the CME information page.
Jung H. Yun, MD
IR/DR Resident
Jefferson Einstein Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
Matthew Callaghan, MD
Attending Interventional Radiologist
Einstein Medical Center, Jefferson Health
Disclosure information not submitted.
Balasubramani Natarajan, MD
Attending Physician
Jefferson Einstein Hospital
Disclosure information not submitted.
Jacob Ramsey, MD
DR Resident Physician, PGY3
Jefferson Einstein Hospital
Disclosure information not submitted.
In recent years, changes to CMS policies regarding reimbursement for E&M billing have created stronger financial incentives to focus IRs attention on inpatient management and documentation within the hospital setting. Thus, it is a crucial part of the job of any IRs practicing in a hospital setting to understand current billing codes to maximize revenue, promote our specialty’s growth, optimize patient care, and capture reimbursement for the inpatient clinical work they are performing.
Clinical Findings/Procedure Details:
The IR department at our institution generated 2,255 RVUs for Inpatient E&M in the 2022 fiscal year and 3,875 for the inpatient E&M in the 2023 fiscal year. Billing codes categorize inpatient clinical encounters as either for a hospital inpatient or a patient in observation care, either for a new or established patient, and either an initial encounter or follow-up. Encounter codes are billed based on the time spent or on the aggregate of points associated with specific components of documentation, which we will summarize in this exhibit. Additionally, we will provide data from our institution to demonstrate the RVUs associated with each code and the total RVUs generated in 2022 and 2023 in the hospital setting.
Conclusion and/or Teaching Points:
IR is already a clinical service, with a large portion of patient management and procedural interventions revolving around hospital-based encounters. However, recent policy changes in CMS reimbursement and billing codes now, more than ever, incentivize IRs to understand E&M billing for hospital-based encounters to ensure the longevity of their practices. By optimizing their E&M billing for hospital encounters, IRs can ensure they continually generate the revenue to grow their practices and to have the resources to optimally provide for their patients. This exhibit will provide examples of inpatient clinical encounters and walk the learner through how to appropriately bill for each encounter.