Inpatient Interventional Radiology Rounding Service - Is It Worth It?

Purpose: The purpose of this study is to assess the impact of a structured academic inpatient rounding service by interventional radiologists (IR) on revenue generation through conscientious billing practices. By analyzing work relative value units (wRVUs) and billed CPT units, this study aims to demonstrate how a dedicated IR rounding service fosters continuity of patient care and collaboration among healthcare professionals while optimizing financial outcomes for the interventional radiology division.

Materials and Methods: This study evaluates the financial impact of a structured academic inpatient IR rounding service at a 650-bed teaching hospital. The retrospective analysis focused on professional billing activities associated with inpatient evaluation and management (E&M) services.
Four IRs actively participated in implementing a structured billable academic inpatient rounding service from January 2023 until August 2024. Each attending physician was assigned one week of inpatient rounding alongside a resident or fellow. Their efforts were concentrated on providing billable standardized E&M services for hospitalized patients requiring IR consultations and post procedural follow-up care.

Professional billing data over the 20 month period was extracted into Microsoft Excel from the hospital's billing software NextGen Healthcare. The billing codes analyzed included inpatient E&M CPT codes 99221-99223 (Initial Hospital Care) and 99231-99233 (Subsequent Hospital Care). Data was compiled and analyzed using Microsoft Excel to calculate the total billable units, wRVUs, and charges generated.

Results: Over the 20-month period, the inpatient IR rounding service generated a total of 1,842 billable CPT units, resulting in 1,400 wRVUs and $186,766 in professional charges. By collaborating closely with the hospital's billing team, we were able to enhance our documentation and coding practices during the second period of the study, resulting in a 21% increase in wRVUs.

Conclusion: Prior to implementing a structured rounding service, our team was routinely rounding on patients but inconsistently capturing charges for our services, leading to missed billing opportunities and inaccurate coding. After initiating a structured rounding service, we achieved significant revenue generation by standardizing documentation and more accurately billing for the care provided. These findings demonstrate the potential value of a dedicated IR rounding service in optimizing clinical care delivery while ensuring appropriate capture of revenue within a teaching hospital environment.